Prevalence of secondary hyperparathyroidism (SHPT) before and under treatment with 1 alpha-hydroxylated derivatives of vitamin D3 in hemodialysis patients of ambulatory hemodialysis centre
Abstract
The prevalence of SHPT and disorders of calcium-phosphorus metabolism were studied in 450 hemodialysis patients of Hemodialysis Centre “FESPHARM” (Moscow). SHPT were diagnosed in accordance with K/DOQI Clinical Practice Guidelines in patients with iPTH levels >300 pg/ml. On admission to the Centre, SHPT was found in 180 patients (40%): mild SHPT (iPTH 300-450 pg/ml) in 13% cases, moderate (iPTH 450-800 pg/ml) SHPT in 16% cases, a severe one (iPTH>800 pg/ml) in 11% of the patients. About one third (131) of centre patients had optimal iPTH levels of 150-300 pg/ml; 144 patients had iPTH levels of less than 150 pg/ml and had signs of adynamic bone disease. The prevalence of SHPT and severity of hyperparathyroidism were significantly lower in patients with diabetic nephropathy in comparison with other diseases. A reciprocal correlation was found between the iPTH level and age of (except diabetic patients). The prevalence of hypercalcemia was about 15% lower than in similar studies described in literature, whereas phosphorus level and prevalence of hyperphosphatemia (about 50%) did not differ significantly from data of other studies. In 152 patients treated the fraction of patients with SHPT was found to decrease from 46% to 27% over 4 years of treatment. Among 70 patients with SHPT treated with 1 alpha-hydroxylated derivatives of vitamin D3 a remission was achieved in 60% cases. In 82 patients with normal iPTH levels the SHPT incidence rate was 10% per year. It increased with duration dialysis treatment.
About the Authors
A. V. Borisov
Центр экстракорпоральной терапии «Фесфарм»
Russian Federation
Russian Federation
A. I. Mordik
Центр экстракорпоральной терапии «Фесфарм»
Russian Federation
Russian Federation
E. V. Borisova
Центр экстракорпоральной терапии «Фесфарм»
Russian Federation
Russian Federation
I. P. Ermakova
НИИТиИО МЗ РФ; г. Москва
Russian Federation
Russian Federation
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Review
For citations:
Borisov A.V., Mordik A.I., Borisova E.V., Ermakova I.P. Prevalence of secondary hyperparathyroidism (SHPT) before and under treatment with 1 alpha-hydroxylated derivatives of vitamin D3 in hemodialysis patients of ambulatory hemodialysis centre. Nephrology and Dialysis. 2006;8(2):147-151. (In Russ.)
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