Certain clinical and biochemical factors, as well as demographic characteristics, increase the risk of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease (CKD), according to a new study.
The study identified the following risk factors: female gender, low calcium, high phosphorus, acidosis, anemia, hypertension, hyperlipidemia, and micro‑inflammation. In multivariable analysis, serum phosphorus and serum creatinine emerged as independent risk factors.
“SHPT is likely to be the result of complex interactions among these factors,” Yudan Wei, MD, of the First Hospital of Jilin University in China, and colleagues wrote in Experimental and Therapeutic Medicine (2016;12:1206-1212).
For the study, the investigators reviewed data on 498 CKD patients seen at the hospital between 2008 and 2012. Of these, 424 patients had elevated serum parathyroid hormone (PTH) levels above 88 pg/mL, and 74 had normal PTH (control group). Blood samples were drawn for laboratory analysis after overnight fasting.
Results showed that serum PTH levels in women were significantly higher than in men. The researchers speculated that estrogen may lead to higher PTH levels.
Elevated PTH also positively correlated with biochemical measures, including serum creatinine, serum phosphorus, C‑reactive protein, triglycerides, total cholesterol, and low‑density lipoprotein cholesterol. Conversely, higher PTH was linked with lower levels of hemoglobin, calcium, and carbon dioxide combining power.
1. Wei Y, Lin J, Yang F, et al. Risk factors associated with secondary hyperparathyroidism in patients with chronic kidney disease. Exp Ther Med 2016 Aug vol 12 issue 2: 1206-1212. doi: 10.3892/etm.2016.3438.