SECONDARY HYPERPARATHYROIDISM AND BONE METABOLISM IN PATIENTS WITH END-STAGE OF CHRONIC KIDNEY DISEASE
DOI:
https://doi.org/10.21856/j-PEP.2020.2.04Keywords:
parathyroid hormone, secondary hyperparathyroidism, chronic kidney disease, bone metabolismAbstract
190 patients with end-stage of chronic kidney disease were clustered using a neural network algorithm to
isolate the group with the most optimal PTH and bone metabolism, followed by analysis in each group of laboratory parameters and patient survival. It was found that at a PTH level of 114-490 pg / ml, optimal indicators of
bone mineral density and metabolism, and better survival rates of dialysis patients are noted. Both a decrease
and an increase in PTH can lead to a critical imbalance in bone metabolism and an adverse outcome, including
loss of BMD and shortened life expectancy. In addition to the level of PTH, an adaptive increase in osteocalcin
and CTx, and an age-associated decrease in BMD are important in determining the prognosis of bone tissue
and patient survival. These factors must be taken into account when diagnosing secondary hyperparathyroidism and determining the tactics of its treatment and observation
References
Horl WH. Nephrol Dial Transplant 2004; 19(5): 2-8. doi: 10.1093/ndt/gfh1049.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. Kidney Int Suppl 2017; 7: S1- 59. doi: http://doi.org/10.1016/j.kisu.2017.04.001
Moe SM, Drueke T, Lameire N, Eknoyan G. Adv Chronic Kidney Dis 2007; 14(1): 3-12. doi: http://doi.org/ 10.1053/j.ackd. 2006.10.005.
Mejía N, Roman-García P, Miar AB, et al. Nefrologia 2011; 31(5): 514-519. doi: http://doi.org/10.3265/Nefrologia.pre2011.
Miller PD. Cleve Clin J Med 2009; 76(12): 715-723. doi: http://doi.org/10.3949/ccjm.76a.08108.
National Kidney Foundation Dialysis Outcomes Quality Initiative (K/DOQI) guidelines, available at: http://www. kidney.org/professionals/kdoqi/guidelines_bone/index.htm.
Eller-Vainicher C, Falchetti A, Gennari L, et al. Eur J Endocrinol 2019; 1: EJE-18-0991. doi:http://doi.org/ 10.1530/EJE-18-0991.
Lee J, Vasikaran S. Ann Lab Med 2012; 32(2): 105-112. doi: http://doi.org/ 10.3343/alm.2012.32.2.105.
Okuno S, Inaba M, Kitatani K, et al. Osteoporos Int 2005; 16 (5): 501-509. doi: http://doi.org/10.1007/s00198-004-1712-4.
Polymeris A, Doumouchtsis K, Grapsa E. Nefrologia 2012; 32(1): 73-78. doi: http://doi.org/10.3265/Nefrologia.pre2011.
ISCD Official Positions. 2019, available at: https://www.iscd.org/ official-positions/ 2019-iscd-official-positions-adult/
Floege J, Kim J, Ireland E, et al. Nephrol Dial Transpl 2011; 26: 1948-1955. doi: http://doi.org/10.1093/ndt/gfq219.
Tentori F, Blayney MJ, Albert JM, et al. Am J Kidney Dis 2008; 52: 519-530. doi: http://doi.org/10.1053/j.ajkd.2008.03.020.
Naves-Daz M, Passlick-Deetjen J, Guinsburg A, et al. Nephrol Dial Transpl 2011; 26: 1938-1947. doi: http://doi.org/10.1093/ ndt/gfq304.
Cannata-Andía JB, Fernández Martín JL. Nefrología 2016; 36: 381-388. doi: http://doi.org/10.1016/j.nefroe.2016.10.001.