High prevalence of hyperparathyroidism among peritoneal dialysis patients: A review of 176 patients

V. Billa, A. Zhong, J. Bargman, S. Vas, P. Y. Wong, D. G. Oreopoulos

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives: Parathyroid dysfunction continues to produce significant morbidity in dialysis patients. Since the introduction of low calcium dialysate for peritoneal dialysis (PD), no large studies have been done to determine the prevalence of parathyroid dysfunction in these patients. This study was done to assess the prevalence of parathyroid disease in the PD population and to determine the risk factors associated with this dysfunction. Design: We analyzed data on 176 patients who received PD at a single center between August 1998 and February 1999. Clinical data, laboratory variables related to parathyroid function, and data pertaining to dialysis treatment and weekly drug dosing were obtained for each patient on two different occasions, approximately 3 months apart. Variables predictive of the development of parathyroid dysfunction were calculated by univariate and multivariate logistic regression analysis. Results: Two-thirds of the patients surveyed had an abnormal intact parathyroid hormone (iPTH) level: 47% had an iPTH level more than three times normal, the mean was 54.6 ± 35.4 pmol\L; 23% had an iPTH value below the upper limit of normal, here the mean was 3.6 ± 1.8 pmol/L. Diabetic patients had lower iPTH levels (22.2 ± 28.4 pmol/L) than nondiabetics (33.9 ± 34.8 pmol/L) (p = 0.02). On multivariate regression analysis, we found that age, duration of dialysis, Kt/V, serum bicarbonate, and serum ionized calcium levels did not significantly affect parathyroid function. Hyperphosphatemia was the only factor that was associated with the development of secondary hyperparathyroidism in this study population (p = 0.029). Conclusion: There is a high prevalence of hyperparathyroidism in the current PD population. Phosphate control is suboptimal and hyperphosphatemia is an independent risk factor for the development of hyperparathyroidism.

Original languageEnglish
Pages (from-to)315-321
Number of pages7
JournalPeritoneal Dialysis International
Volume20
Issue number3
Publication statusPublished - 2000

Fingerprint

Hyperparathyroidism
Peritoneal Dialysis
Parathyroid Hormone
Hyperphosphatemia
Dialysis
Parathyroid Diseases
Regression Analysis
Population
Calcium
Secondary Hyperparathyroidism
Dialysis Solutions
Bicarbonates
Serum
Multivariate Analysis
Logistic Models
Phosphates
Morbidity
Pharmaceutical Preparations

Keywords

  • Hyperparathyroidism
  • Hyperphosphatemia
  • Renal osteodystrophy

ASJC Scopus subject areas

  • Nephrology

Cite this

Billa, V., Zhong, A., Bargman, J., Vas, S., Wong, P. Y., & Oreopoulos, D. G. (2000). High prevalence of hyperparathyroidism among peritoneal dialysis patients: A review of 176 patients. Peritoneal Dialysis International, 20(3), 315-321.

High prevalence of hyperparathyroidism among peritoneal dialysis patients : A review of 176 patients. / Billa, V.; Zhong, A.; Bargman, J.; Vas, S.; Wong, P. Y.; Oreopoulos, D. G.

In: Peritoneal Dialysis International, Vol. 20, No. 3, 2000, p. 315-321.

Research output: Contribution to journalArticle

Billa, V, Zhong, A, Bargman, J, Vas, S, Wong, PY & Oreopoulos, DG 2000, 'High prevalence of hyperparathyroidism among peritoneal dialysis patients: A review of 176 patients', Peritoneal Dialysis International, vol. 20, no. 3, pp. 315-321.
Billa, V. ; Zhong, A. ; Bargman, J. ; Vas, S. ; Wong, P. Y. ; Oreopoulos, D. G. / High prevalence of hyperparathyroidism among peritoneal dialysis patients : A review of 176 patients. In: Peritoneal Dialysis International. 2000 ; Vol. 20, No. 3. pp. 315-321.
@article{cb21a949b3c9489ea40573f96c0a8707,
title = "High prevalence of hyperparathyroidism among peritoneal dialysis patients: A review of 176 patients",
abstract = "Objectives: Parathyroid dysfunction continues to produce significant morbidity in dialysis patients. Since the introduction of low calcium dialysate for peritoneal dialysis (PD), no large studies have been done to determine the prevalence of parathyroid dysfunction in these patients. This study was done to assess the prevalence of parathyroid disease in the PD population and to determine the risk factors associated with this dysfunction. Design: We analyzed data on 176 patients who received PD at a single center between August 1998 and February 1999. Clinical data, laboratory variables related to parathyroid function, and data pertaining to dialysis treatment and weekly drug dosing were obtained for each patient on two different occasions, approximately 3 months apart. Variables predictive of the development of parathyroid dysfunction were calculated by univariate and multivariate logistic regression analysis. Results: Two-thirds of the patients surveyed had an abnormal intact parathyroid hormone (iPTH) level: 47{\%} had an iPTH level more than three times normal, the mean was 54.6 ± 35.4 pmol\L; 23{\%} had an iPTH value below the upper limit of normal, here the mean was 3.6 ± 1.8 pmol/L. Diabetic patients had lower iPTH levels (22.2 ± 28.4 pmol/L) than nondiabetics (33.9 ± 34.8 pmol/L) (p = 0.02). On multivariate regression analysis, we found that age, duration of dialysis, Kt/V, serum bicarbonate, and serum ionized calcium levels did not significantly affect parathyroid function. Hyperphosphatemia was the only factor that was associated with the development of secondary hyperparathyroidism in this study population (p = 0.029). Conclusion: There is a high prevalence of hyperparathyroidism in the current PD population. Phosphate control is suboptimal and hyperphosphatemia is an independent risk factor for the development of hyperparathyroidism.",
keywords = "Hyperparathyroidism, Hyperphosphatemia, Renal osteodystrophy",
author = "V. Billa and A. Zhong and J. Bargman and S. Vas and Wong, {P. Y.} and Oreopoulos, {D. G.}",
year = "2000",
language = "English",
volume = "20",
pages = "315--321",
journal = "Peritoneal Dialysis International",
issn = "0896-8608",
publisher = "Multimed Inc.",
number = "3",

}

TY - JOUR

T1 - High prevalence of hyperparathyroidism among peritoneal dialysis patients

T2 - A review of 176 patients

AU - Billa, V.

AU - Zhong, A.

AU - Bargman, J.

AU - Vas, S.

AU - Wong, P. Y.

AU - Oreopoulos, D. G.

PY - 2000

Y1 - 2000

N2 - Objectives: Parathyroid dysfunction continues to produce significant morbidity in dialysis patients. Since the introduction of low calcium dialysate for peritoneal dialysis (PD), no large studies have been done to determine the prevalence of parathyroid dysfunction in these patients. This study was done to assess the prevalence of parathyroid disease in the PD population and to determine the risk factors associated with this dysfunction. Design: We analyzed data on 176 patients who received PD at a single center between August 1998 and February 1999. Clinical data, laboratory variables related to parathyroid function, and data pertaining to dialysis treatment and weekly drug dosing were obtained for each patient on two different occasions, approximately 3 months apart. Variables predictive of the development of parathyroid dysfunction were calculated by univariate and multivariate logistic regression analysis. Results: Two-thirds of the patients surveyed had an abnormal intact parathyroid hormone (iPTH) level: 47% had an iPTH level more than three times normal, the mean was 54.6 ± 35.4 pmol\L; 23% had an iPTH value below the upper limit of normal, here the mean was 3.6 ± 1.8 pmol/L. Diabetic patients had lower iPTH levels (22.2 ± 28.4 pmol/L) than nondiabetics (33.9 ± 34.8 pmol/L) (p = 0.02). On multivariate regression analysis, we found that age, duration of dialysis, Kt/V, serum bicarbonate, and serum ionized calcium levels did not significantly affect parathyroid function. Hyperphosphatemia was the only factor that was associated with the development of secondary hyperparathyroidism in this study population (p = 0.029). Conclusion: There is a high prevalence of hyperparathyroidism in the current PD population. Phosphate control is suboptimal and hyperphosphatemia is an independent risk factor for the development of hyperparathyroidism.

AB - Objectives: Parathyroid dysfunction continues to produce significant morbidity in dialysis patients. Since the introduction of low calcium dialysate for peritoneal dialysis (PD), no large studies have been done to determine the prevalence of parathyroid dysfunction in these patients. This study was done to assess the prevalence of parathyroid disease in the PD population and to determine the risk factors associated with this dysfunction. Design: We analyzed data on 176 patients who received PD at a single center between August 1998 and February 1999. Clinical data, laboratory variables related to parathyroid function, and data pertaining to dialysis treatment and weekly drug dosing were obtained for each patient on two different occasions, approximately 3 months apart. Variables predictive of the development of parathyroid dysfunction were calculated by univariate and multivariate logistic regression analysis. Results: Two-thirds of the patients surveyed had an abnormal intact parathyroid hormone (iPTH) level: 47% had an iPTH level more than three times normal, the mean was 54.6 ± 35.4 pmol\L; 23% had an iPTH value below the upper limit of normal, here the mean was 3.6 ± 1.8 pmol/L. Diabetic patients had lower iPTH levels (22.2 ± 28.4 pmol/L) than nondiabetics (33.9 ± 34.8 pmol/L) (p = 0.02). On multivariate regression analysis, we found that age, duration of dialysis, Kt/V, serum bicarbonate, and serum ionized calcium levels did not significantly affect parathyroid function. Hyperphosphatemia was the only factor that was associated with the development of secondary hyperparathyroidism in this study population (p = 0.029). Conclusion: There is a high prevalence of hyperparathyroidism in the current PD population. Phosphate control is suboptimal and hyperphosphatemia is an independent risk factor for the development of hyperparathyroidism.

KW - Hyperparathyroidism

KW - Hyperphosphatemia

KW - Renal osteodystrophy

UR - http://www.scopus.com/inward/record.url?scp=0033916628&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033916628&partnerID=8YFLogxK

M3 - Article

C2 - 10898049

AN - SCOPUS:0033916628

VL - 20

SP - 315

EP - 321

JO - Peritoneal Dialysis International

JF - Peritoneal Dialysis International

SN - 0896-8608

IS - 3

ER -