PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000300156 |
Resumo: | ABSTRACT Introduction: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) is a major complication in hemodialysis (HD) patients. Serum intact parathyroid hormone (iPTH) has been associated with prognosis in these patients, however, the optimal range to reduce mortality remains unknown. Methods: We conducted a retrospective study of incident HD patients, who were categorized into 4 groups according to iPTH serum level: <150 pg/mL, 150-300 pg/mL, 301-600 pg/mL and >600 pg/mL. All-cause and cardiovascular mortality over a mean follow-up of 3 years was assessed using standard survival methods. Results: One hundred and forty-nine patients were included. Patients with low iPTH presented low serum albumin, phosphorus, and bonespecific alkaline phosphatase (BAP), increased c-reactive protein (CRP) and higher serum bicarbonate (p<0.05). Those with iPTH <150 pg/mL had an increased risk of all-cause and cardiovascular mortality, when compared to those with iPTH 301-600 pg/mL (HR: 0.59; 95% CI: 0.36-0.96; p=0.035) and iPTH >600 pg/mL (HR: 0.39; 95% CI: 0.20-0.78; p=0.008), even after adjusting for potential confounding factors as age, albumin, and comorbidities (diabetes, congestive heart failure (CHF), and hypertension). Discussion: PTH levels were associated with all-cause and cardiovascular mortality risk in our cohort of incident HD patients. Our results suggest that patients with low iPTH at HD initiation had an increased mortality risk, which may reflect a frail group of patients with anorexia, sarcopenia, malnutrition, and inflammation. |
id |
RCAP_5dc4f68b23bc0e9ade33a05902b1e889 |
---|---|
oai_identifier_str |
oai:scielo:S0872-01692022000300156 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis PatientsChronic Kidney Disease-Mineral and Bone Disorder/etiologyParathyroid HormoneRenal Dialysis/adverse effectsABSTRACT Introduction: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) is a major complication in hemodialysis (HD) patients. Serum intact parathyroid hormone (iPTH) has been associated with prognosis in these patients, however, the optimal range to reduce mortality remains unknown. Methods: We conducted a retrospective study of incident HD patients, who were categorized into 4 groups according to iPTH serum level: <150 pg/mL, 150-300 pg/mL, 301-600 pg/mL and >600 pg/mL. All-cause and cardiovascular mortality over a mean follow-up of 3 years was assessed using standard survival methods. Results: One hundred and forty-nine patients were included. Patients with low iPTH presented low serum albumin, phosphorus, and bonespecific alkaline phosphatase (BAP), increased c-reactive protein (CRP) and higher serum bicarbonate (p<0.05). Those with iPTH <150 pg/mL had an increased risk of all-cause and cardiovascular mortality, when compared to those with iPTH 301-600 pg/mL (HR: 0.59; 95% CI: 0.36-0.96; p=0.035) and iPTH >600 pg/mL (HR: 0.39; 95% CI: 0.20-0.78; p=0.008), even after adjusting for potential confounding factors as age, albumin, and comorbidities (diabetes, congestive heart failure (CHF), and hypertension). Discussion: PTH levels were associated with all-cause and cardiovascular mortality risk in our cohort of incident HD patients. Our results suggest that patients with low iPTH at HD initiation had an increased mortality risk, which may reflect a frail group of patients with anorexia, sarcopenia, malnutrition, and inflammation.Sociedade Portuguesa de Nefrologia2022-09-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000300156Portuguese Journal of Nephrology & Hypertension v.36 n.3 2022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000300156Roldão,MarisaEscoli,RacheleGonçalves,HernâniSofia,FloraLopes,KarinaSantos,Pauloinfo:eu-repo/semantics/openAccess2024-02-06T17:05:14Zoai:scielo:S0872-01692022000300156Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:19:08.133234Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
title |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
spellingShingle |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients Roldão,Marisa Chronic Kidney Disease-Mineral and Bone Disorder/etiology Parathyroid Hormone Renal Dialysis/adverse effects |
title_short |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
title_full |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
title_fullStr |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
title_full_unstemmed |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
title_sort |
PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
author |
Roldão,Marisa |
author_facet |
Roldão,Marisa Escoli,Rachele Gonçalves,Hernâni Sofia,Flora Lopes,Karina Santos,Paulo |
author_role |
author |
author2 |
Escoli,Rachele Gonçalves,Hernâni Sofia,Flora Lopes,Karina Santos,Paulo |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Roldão,Marisa Escoli,Rachele Gonçalves,Hernâni Sofia,Flora Lopes,Karina Santos,Paulo |
dc.subject.por.fl_str_mv |
Chronic Kidney Disease-Mineral and Bone Disorder/etiology Parathyroid Hormone Renal Dialysis/adverse effects |
topic |
Chronic Kidney Disease-Mineral and Bone Disorder/etiology Parathyroid Hormone Renal Dialysis/adverse effects |
description |
ABSTRACT Introduction: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) is a major complication in hemodialysis (HD) patients. Serum intact parathyroid hormone (iPTH) has been associated with prognosis in these patients, however, the optimal range to reduce mortality remains unknown. Methods: We conducted a retrospective study of incident HD patients, who were categorized into 4 groups according to iPTH serum level: <150 pg/mL, 150-300 pg/mL, 301-600 pg/mL and >600 pg/mL. All-cause and cardiovascular mortality over a mean follow-up of 3 years was assessed using standard survival methods. Results: One hundred and forty-nine patients were included. Patients with low iPTH presented low serum albumin, phosphorus, and bonespecific alkaline phosphatase (BAP), increased c-reactive protein (CRP) and higher serum bicarbonate (p<0.05). Those with iPTH <150 pg/mL had an increased risk of all-cause and cardiovascular mortality, when compared to those with iPTH 301-600 pg/mL (HR: 0.59; 95% CI: 0.36-0.96; p=0.035) and iPTH >600 pg/mL (HR: 0.39; 95% CI: 0.20-0.78; p=0.008), even after adjusting for potential confounding factors as age, albumin, and comorbidities (diabetes, congestive heart failure (CHF), and hypertension). Discussion: PTH levels were associated with all-cause and cardiovascular mortality risk in our cohort of incident HD patients. Our results suggest that patients with low iPTH at HD initiation had an increased mortality risk, which may reflect a frail group of patients with anorexia, sarcopenia, malnutrition, and inflammation. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-09-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000300156 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000300156 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000300156 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
dc.source.none.fl_str_mv |
Portuguese Journal of Nephrology & Hypertension v.36 n.3 2022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799137280852492288 |