Patients with chronic kidney disease (CKD) who develop secondary hyperparathyroidism (SHPT) have different clinical profiles depending on their diabetes status, according to a new study from Spain.
Investigators led by Jose Carlos Arevalo-Lorido, MD, of Zafra County Hospital in Badajoz, Spain, examined the medical records of 409 patients with stage 3 or 4 CKD from internal medicine wards at 14 hospitals from spring 2013. Of these, 214 had type 2 diabetes. SHPT, defined as intact parathyroid hormone (PTH) levels of 70 pg/mL or above, was found in 60.4% of patients with diabetes and 65% of those without the disease, a non-significant difference between the groups. PTH levels also did not differ significantly between groups (121.4 vs. 122.9 pg/mL).
Among patients with SHPT, diabetics were significantly younger than non-diabetics (79.5 vs. 82.3 years) and more likely to have hypertension (97.1% vs. 86.7%), dyslipidemia (82.1% vs.51.8%), and co-existing illnesses, according to results published online in Diabetes & Metabolic Syndrome. The diabetics also were more likely to have microalbuminuria and lower vitamin D levels.
“A better understanding of this profile should be useful in order to establish an early diagnosis and treatment,” Dr. Arevalo-Lorido and colleagues stated.
In addition, diabetics were treated with statins more frequently. These medications may have osteogenic effects and should be targeted for additional research, the researchers suggested.
As this study was cross-sectional, it could not account for differences due to time. The investigators also did not have complete measurements of blood pressure, lipids, drug dosages, or body mass index.
- Arévalo-Lorido JC, Carretero-Gómez J, García-Sánchez F, et al. Secondary hyperparathyroidism prevalence and profile, between diabetic and non-diabetic patients with stage 3 to 4 chronic kidney disease attended in internal medicine wards. MiPTH study. Diabetes Metab Syndr. doi: 10.1016/j.dsx.2016.01.011.