Introduction: Parathyroid hormone (PTH) starts to rise very early in the course of kidney disease. As kidney disease progresses, plasma levels of vitamin D and calcium begin to decline, thus contributing to greater secretion of PTH. In addition, the retention of phosphate further increases PTH secretion independent of calcium and vitamin D levels. Continued stimulation of PTH secretion leads to irreversible parathyroid gland hyperplasia.
Objectives: To measure the PTH levels in hemodialysis patients and relate with the duration of hemodialysis.
Methods: Forty-two stable hemodialysis patients, 22 (52.4%) women and 20 (47.6%) men with a mean age of 66.1±10.7 of years were included in the study. The average duration of hemodialysis was 213 years, with two or three dialysis session per week.
Blood samples were obtained prior to a dialysis session, after an overnight fast. The serum PTH concentrations were determined using an immunoreactive measuring (Elecsys, Roche).
Results: Six (14.3%) patients exhibited elevated PTH levels (>250 pg/ml).
in two patients the duration of hemodialysis was 13 years
in two patients was 8 years
in one patient was 6 years and
in one patient was 5 years.
The PTH level was positively correlated with the duration of hemodialysis.
Conclusion: PTH is the major determinant of rates of bone remodeling and turnover in hemodialysis patients with end-stage renal disease; accurate assessments of plasma PTH levels are essential not only for estimating the bone metabolism of renal osteodystrophy but also for appropriately monitoring the treatment of secondary hyperparathyroidism.
Prague, Czech Republic
24 - 28 Apr 2010
European Society of Endocrinology