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ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 3  |  Page : 932-937

Dialysis vintage and risk factors of hyperparathyroidism in hemodialysis patients


1 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Nephrology, Health Insurance Sector, Tanta, Gharbia Governorate, Egypt

Correspondence Address:
Mahmoud A Elsayed
Department of Nephrology, Health Insurance Sector, Tanta, Gharbia Governorate
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_797_17

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Objective The objective of this study was to study the risk factors of hyperparathyroidism based on hemodialysis vintage (duration in months or years that hemodialysis patients spend on dialysis). Background Hyperparathyroidism is associated with high risk of fractures, cardiovascular morbidity, and death; therefore, it is important to identify risk factors predicting or influencing parathyroid gland secretion. Patients and methods Patients were divided into two groups: short dialysis vintage (<10 years), and long dialysis vintage (≥10 years). Each group was further divided at parathyroid hormone (PTH) cutoff value of 300 pg/ml. Results Short dialysis vintage patients with PTH more than 300 pg/ml have higher alkaline phosphatase (147.9 ± 101.4 vs. 102.1 ± 89.18; P = 0.009), phosphorus (5.913 ± 1.621 vs. 5.044 ± 1.387; P = 0.048), calcium phosphate product (49.60 ± 13.45 vs. 42.35 ± 13.61; P = 0.04), and serum creatinine (10.8 ± 3.353 vs. 8.96 ± 2.311; P = 0.005 for predialysis serum creatinine and 4.987 ± 1.364 vs. 4.035 ± 1.426; P = 0.007 for postdialysis serum creatinine) compared with nonhigh PTH group. Long dialysis vintage patients with PTH more than 300 pg/ml have higher alkaline phosphatase (222.1 ± 184.7 vs. 99 ± 29.47; P = 0.024), lower serum sodium (137.3 ± 2.8 vs. 141.4 ± 2.937; P = 0.004), and lower mean arterial blood pressure (81.42 ± 14.65 vs. 96.38 ± 12.87; P = 0.019) compared with nonhigh PTH group. Conclusion Serum alkaline phosphatase, phosphorus, calcium phosphate product, and serum creatinine were found to be associated with hyperparathyroidism in short hemodialysis vintage patients (<10 years), but this association was lost in long dialysis vintage patients (≥10 years) except for 'alkaline phosphatase'. Moreover, serum sodium was found to be associated with hyperparathyroidism in long dialysis vintage patients.


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