Low Parathyroid Hormone Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2022 May 31

PMID 35634511

Authors

Wang Guo

Huixian Zhang

Yamei Zhang

Hongdong Huang

Wenhu Liu

Zongli Diao

Affiliations

Soon will be listed here.

Abstract

Introduction: Low serum parathyroid hormone (PTH) and secondary hyperparathyroidism (SHPT) are very common in patients undergoing hemodialysis. However, it remains unclear which of these has a lower mortality.

Objective: In this study, we compared outcomes between hemodialysis patients with low PTH and those with SHPT.

Methods: This was a multi-center, retrospective, matched cohort study. Median intact PTH (iPTH) was used as the cutoff for allocating participants to low PTH (iPTH<100 pg/mL) and SHPT groups (iPTH ≥600 pg/mL). Sex, diabetes, age, and dialysis vintage were matched between the groups. The primary outcome was all-cause death at 72 months.

Results: The study cohort comprised 2282 patients (1166 in each study group). Prior to matching, the primary outcome occurred in 429/1166 patients (36.79%) in the low PTH group and in 284/1116 (25.45%) in the SHPT group. There were no significant differences in all-cause death between the groups according to multivariable Cox regression (P=0.423). The hazard ratio for low PTH versus SHPT was 1.08 (95% confidence interval, 0.90-1.30). Propensity matching created 619 pairs of patients. Baseline characteristics, including age, sex, diabetes, and dialysis vintage were comparable between the groups. The primary outcome occurred in 195/619 patients (31.50%) in the low PTH group and in 193/619 (31.18%) in the SHPT group. There were no significant differences in all-cause death between the groups according to multivariable Cox regression (P=0.43). The adjusted hazard ratio for low PTH versus SHPT was 1.10 (95% confidence interval, 0.87-1.39).

Conclusions: Hemodialysis patients with low PTH have similar all-cause death rates to the rates for those with SHPT.

Citing Articles

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