Correlates of parathyroid hormone concentration in hemodialysis patients

Jinnan Li, Miklos Z. Molnar, Joshua J. Zaritsky, John J. Sim, Elani Streja, Csaba Kovesdy, Isidro Salusky, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

BackgroundThe implications of chemical hyperparathyroidism on bone and mineral metabolism measures in maintenance hemodialysis (MHD) are not well known. We hypothesized that a higher serum intact parathyroid hormone (iPTH) level is associated with the higher likelihood of hyperphosphatemia, hyperphosphatasemia [high serum alkaline phosphatase (ALP) levels] and hypercalcemia.MethodsOver an 8-year period (July 2001-June 2009), we identified 106 760 MHD patients with iPTH and calcium (Ca), phosphorous (P) and ALP data from a large dialysis clinic. Logistic regression models were examined to assess the association between serum iPTH increments and the likelihood of hyperphosphatemia (P ≥5.5 mg/dL), hypercalcemia (Ca ≥10.2 mg/dL) and hyperphosphatasemia (ALP ≥120 U/L).ResultsPatients were 61 ± 16 years old and included 45% women, 59% diabetics and 33% Blacks. Compared with an iPTH level of 100 to <200 pg/mL, patients with an iPTH level of 600-700, 700 to <800 and ≥800 pg/mL had 122% (OR: 2.22, 95% CI: 2.04-2.41), 153% (OR: 2.53, 95% CI: 2.29-2.80) and 243% (OR: 3.43, 95% CI: 3.22-3.66) higher risk of hyperphosphatemia, respectively, and had 109% (OR: 2.09, 95% CI: 1.93-2.26), 130% (OR: 2.30, 95% CI: 2.10-2.52) and 376% (OR: 4.76, 95% CI: 4.50-5.04) higher risk of hyperphosphatasemia, respectively. Compared with an iPTH level of 100 to <200 pg/mL, both the low iPTH (<100 pg/mL, OR: 2.45, 95% CI: 2.27-2.64) and the high iPTH (≥800 pg/mL: OR: 2.13, 95% CI: 1.95-2.33) levels were associated with hypercalcemia.ConclusionsHigher levels of iPTH are incremental correlates of hyperphosphatemia and hyperphosphatasemia, whereas both very low and high PTH levels are linked to hypercalcemia. If these associations are causal, correction of hyperparathyroidism may have overarching implications on bone and mineral disorders in MHD patients.

Original languageEnglish (US)
Pages (from-to)1516-1525
Number of pages10
JournalNephrology Dialysis Transplantation
Volume28
Issue number6
DOIs
StatePublished - Jun 1 2013

Fingerprint

Parathyroid Hormone
Renal Dialysis
Hyperphosphatemia
Hypercalcemia
Alkaline Phosphatase
Hyperparathyroidism
Minerals
Logistic Models
Serum
Calcium
Bone and Bones
Dialysis
Maintenance

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Li, J., Molnar, M. Z., Zaritsky, J. J., Sim, J. J., Streja, E., Kovesdy, C., ... Kalantar-Zadeh, K. (2013). Correlates of parathyroid hormone concentration in hemodialysis patients. Nephrology Dialysis Transplantation, 28(6), 1516-1525. https://doi.org/10.1093/ndt/gfs598

Correlates of parathyroid hormone concentration in hemodialysis patients. / Li, Jinnan; Molnar, Miklos Z.; Zaritsky, Joshua J.; Sim, John J.; Streja, Elani; Kovesdy, Csaba; Salusky, Isidro; Kalantar-Zadeh, Kamyar.

In: Nephrology Dialysis Transplantation, Vol. 28, No. 6, 01.06.2013, p. 1516-1525.

Research output: Contribution to journalArticle

Li, J, Molnar, MZ, Zaritsky, JJ, Sim, JJ, Streja, E, Kovesdy, C, Salusky, I & Kalantar-Zadeh, K 2013, 'Correlates of parathyroid hormone concentration in hemodialysis patients', Nephrology Dialysis Transplantation, vol. 28, no. 6, pp. 1516-1525. https://doi.org/10.1093/ndt/gfs598
Li, Jinnan ; Molnar, Miklos Z. ; Zaritsky, Joshua J. ; Sim, John J. ; Streja, Elani ; Kovesdy, Csaba ; Salusky, Isidro ; Kalantar-Zadeh, Kamyar. / Correlates of parathyroid hormone concentration in hemodialysis patients. In: Nephrology Dialysis Transplantation. 2013 ; Vol. 28, No. 6. pp. 1516-1525.
@article{f888f711396243ee85a7e58ece14c037,
title = "Correlates of parathyroid hormone concentration in hemodialysis patients",
abstract = "BackgroundThe implications of chemical hyperparathyroidism on bone and mineral metabolism measures in maintenance hemodialysis (MHD) are not well known. We hypothesized that a higher serum intact parathyroid hormone (iPTH) level is associated with the higher likelihood of hyperphosphatemia, hyperphosphatasemia [high serum alkaline phosphatase (ALP) levels] and hypercalcemia.MethodsOver an 8-year period (July 2001-June 2009), we identified 106 760 MHD patients with iPTH and calcium (Ca), phosphorous (P) and ALP data from a large dialysis clinic. Logistic regression models were examined to assess the association between serum iPTH increments and the likelihood of hyperphosphatemia (P ≥5.5 mg/dL), hypercalcemia (Ca ≥10.2 mg/dL) and hyperphosphatasemia (ALP ≥120 U/L).ResultsPatients were 61 ± 16 years old and included 45{\%} women, 59{\%} diabetics and 33{\%} Blacks. Compared with an iPTH level of 100 to <200 pg/mL, patients with an iPTH level of 600-700, 700 to <800 and ≥800 pg/mL had 122{\%} (OR: 2.22, 95{\%} CI: 2.04-2.41), 153{\%} (OR: 2.53, 95{\%} CI: 2.29-2.80) and 243{\%} (OR: 3.43, 95{\%} CI: 3.22-3.66) higher risk of hyperphosphatemia, respectively, and had 109{\%} (OR: 2.09, 95{\%} CI: 1.93-2.26), 130{\%} (OR: 2.30, 95{\%} CI: 2.10-2.52) and 376{\%} (OR: 4.76, 95{\%} CI: 4.50-5.04) higher risk of hyperphosphatasemia, respectively. Compared with an iPTH level of 100 to <200 pg/mL, both the low iPTH (<100 pg/mL, OR: 2.45, 95{\%} CI: 2.27-2.64) and the high iPTH (≥800 pg/mL: OR: 2.13, 95{\%} CI: 1.95-2.33) levels were associated with hypercalcemia.ConclusionsHigher levels of iPTH are incremental correlates of hyperphosphatemia and hyperphosphatasemia, whereas both very low and high PTH levels are linked to hypercalcemia. If these associations are causal, correction of hyperparathyroidism may have overarching implications on bone and mineral disorders in MHD patients.",
author = "Jinnan Li and Molnar, {Miklos Z.} and Zaritsky, {Joshua J.} and Sim, {John J.} and Elani Streja and Csaba Kovesdy and Isidro Salusky and Kamyar Kalantar-Zadeh",
year = "2013",
month = "6",
day = "1",
doi = "10.1093/ndt/gfs598",
language = "English (US)",
volume = "28",
pages = "1516--1525",
journal = "Nephrology Dialysis Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Correlates of parathyroid hormone concentration in hemodialysis patients

AU - Li, Jinnan

AU - Molnar, Miklos Z.

AU - Zaritsky, Joshua J.

AU - Sim, John J.

AU - Streja, Elani

AU - Kovesdy, Csaba

AU - Salusky, Isidro

AU - Kalantar-Zadeh, Kamyar

PY - 2013/6/1

Y1 - 2013/6/1

N2 - BackgroundThe implications of chemical hyperparathyroidism on bone and mineral metabolism measures in maintenance hemodialysis (MHD) are not well known. We hypothesized that a higher serum intact parathyroid hormone (iPTH) level is associated with the higher likelihood of hyperphosphatemia, hyperphosphatasemia [high serum alkaline phosphatase (ALP) levels] and hypercalcemia.MethodsOver an 8-year period (July 2001-June 2009), we identified 106 760 MHD patients with iPTH and calcium (Ca), phosphorous (P) and ALP data from a large dialysis clinic. Logistic regression models were examined to assess the association between serum iPTH increments and the likelihood of hyperphosphatemia (P ≥5.5 mg/dL), hypercalcemia (Ca ≥10.2 mg/dL) and hyperphosphatasemia (ALP ≥120 U/L).ResultsPatients were 61 ± 16 years old and included 45% women, 59% diabetics and 33% Blacks. Compared with an iPTH level of 100 to <200 pg/mL, patients with an iPTH level of 600-700, 700 to <800 and ≥800 pg/mL had 122% (OR: 2.22, 95% CI: 2.04-2.41), 153% (OR: 2.53, 95% CI: 2.29-2.80) and 243% (OR: 3.43, 95% CI: 3.22-3.66) higher risk of hyperphosphatemia, respectively, and had 109% (OR: 2.09, 95% CI: 1.93-2.26), 130% (OR: 2.30, 95% CI: 2.10-2.52) and 376% (OR: 4.76, 95% CI: 4.50-5.04) higher risk of hyperphosphatasemia, respectively. Compared with an iPTH level of 100 to <200 pg/mL, both the low iPTH (<100 pg/mL, OR: 2.45, 95% CI: 2.27-2.64) and the high iPTH (≥800 pg/mL: OR: 2.13, 95% CI: 1.95-2.33) levels were associated with hypercalcemia.ConclusionsHigher levels of iPTH are incremental correlates of hyperphosphatemia and hyperphosphatasemia, whereas both very low and high PTH levels are linked to hypercalcemia. If these associations are causal, correction of hyperparathyroidism may have overarching implications on bone and mineral disorders in MHD patients.

AB - BackgroundThe implications of chemical hyperparathyroidism on bone and mineral metabolism measures in maintenance hemodialysis (MHD) are not well known. We hypothesized that a higher serum intact parathyroid hormone (iPTH) level is associated with the higher likelihood of hyperphosphatemia, hyperphosphatasemia [high serum alkaline phosphatase (ALP) levels] and hypercalcemia.MethodsOver an 8-year period (July 2001-June 2009), we identified 106 760 MHD patients with iPTH and calcium (Ca), phosphorous (P) and ALP data from a large dialysis clinic. Logistic regression models were examined to assess the association between serum iPTH increments and the likelihood of hyperphosphatemia (P ≥5.5 mg/dL), hypercalcemia (Ca ≥10.2 mg/dL) and hyperphosphatasemia (ALP ≥120 U/L).ResultsPatients were 61 ± 16 years old and included 45% women, 59% diabetics and 33% Blacks. Compared with an iPTH level of 100 to <200 pg/mL, patients with an iPTH level of 600-700, 700 to <800 and ≥800 pg/mL had 122% (OR: 2.22, 95% CI: 2.04-2.41), 153% (OR: 2.53, 95% CI: 2.29-2.80) and 243% (OR: 3.43, 95% CI: 3.22-3.66) higher risk of hyperphosphatemia, respectively, and had 109% (OR: 2.09, 95% CI: 1.93-2.26), 130% (OR: 2.30, 95% CI: 2.10-2.52) and 376% (OR: 4.76, 95% CI: 4.50-5.04) higher risk of hyperphosphatasemia, respectively. Compared with an iPTH level of 100 to <200 pg/mL, both the low iPTH (<100 pg/mL, OR: 2.45, 95% CI: 2.27-2.64) and the high iPTH (≥800 pg/mL: OR: 2.13, 95% CI: 1.95-2.33) levels were associated with hypercalcemia.ConclusionsHigher levels of iPTH are incremental correlates of hyperphosphatemia and hyperphosphatasemia, whereas both very low and high PTH levels are linked to hypercalcemia. If these associations are causal, correction of hyperparathyroidism may have overarching implications on bone and mineral disorders in MHD patients.

UR - http://www.scopus.com/inward/record.url?scp=84879852418&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879852418&partnerID=8YFLogxK

U2 - 10.1093/ndt/gfs598

DO - 10.1093/ndt/gfs598

M3 - Article

VL - 28

SP - 1516

EP - 1525

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

SN - 0931-0509

IS - 6

ER -