Elevated Parathyroid Hormone Linked to Obesity in CKD Patients

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Obesity in CKD patients is associated with increased parathyroid hormone (PTH) levels independent of estimated glomerular filtration rate (eGFR).
  • Compared with patients in the lowest BMI quartile, those in the second, third, and fourth quartiles had PTH levels that were 7.3%, 11.9%, and 18.1% higher, respectively.
  • The investigators concluded that obesity may be another target in the management of secondary hyperparathyroidism in CKD patients.


Obesity in CKD patients is associated with increased parathyroid hormone (PTH) levels independent of estimated glomerular filtration rate (eGFR), according to a study presented at ASN's Renal Week 2009.

Georges Saab, MD, of the University of Missouri-Columbia School of Medicine in Columbia, and colleagues studied 4,551 individuals with CKD (eGFR below 60 mL/min/1.73 m2) in the National Kidney Foundation's Kidney Early Evaluation Program. The investigators classified subjects into quartiles of BMI (kg/m2): 25.7 or less; 25.8 to 29.3; 29.4 to 33.7; and greater than 33.7.

The study population had a mean age of 68 years, 68.5% of subjects were female, 69% were white, and 37% were diabetic. Microalbuminuria (urine albumin to creatinine ratio of 30 mg/g or higher) was presented in 23% of subjects, and 50% had elevated PTH (levels above 70 pg/mL).

After adjusting for age, race, gender, eGFR, calcium, phosphorus, diabetes, and microalbuminuria, and compared with patients in the lowest BMI quartile, those in the second, third, and fourth quartiles had PTH levels that were 7.3%, 11.9%, and 18.1% higher, respectively. They also had a significant 26%, 38%, and 66% increased risk of having elevated PTH.

The investigators concluded that obesity may be another target in the management of secondary hyperparathyroidism in CKD patients.

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