title: Secondary hyperparathyroidism in chronic hemodialysis patients: prevalence and race.
abstract: Secondary hyperparathyroidism is a common complication of renal failure. The exact prevalence in chronic hemodialysis patients in not known. We evaluated 122 patients who were receiving maintenance hemodialysis for at least 12 months in 2 dialysis centers in mid Michigan. Seventy-eight percent of the patients had iPTH above 200 pg/mL (mean 481 pg/mL), 19% had iPTH within the accepted normal range (mean 155 pg/mL), while 3% had level below 100 (mean 53 pg/mL). Phosphate, calcium, calcium phosphate product, age and time on dialysis are the important factors correlating with elevated iPTH. There was no significant difference in iPTH between diabetic and nondiabetic patients with mean iPTH of 403 pg/mL and 407 pg/mL respectively. Black patients had a statistically significant elevated iPTH compared with white patients with a mean iPTH of 438 pg/mL and 283 pg/mL respectively (p < or = 0.004). Factors that predict the response to vitamin D therapy need to be evaluated to help reduce the high prevalence of secondary hyperparathyroidism. The patterns of bone disease in black patients need to be evaluated to further define the accepted normal iPTH range for this population.
authors.affiliation: Hurley Medical Center and Michigan State University, Flint Campus, Flint, Michigan, USA. alikowda@hotmail.com
authors.forename: Ali
authors.initials: A
authors.lastname: Owda
authors.forename: Huda
authors.initials: H
authors.lastname: Elhwairis
authors.forename: Sridhar
authors.initials: S
authors.lastname: Narra
authors.forename: Heather
authors.initials: H
authors.lastname: Towery
authors.forename: Sayed
authors.initials: S
authors.lastname: Osama
mesh_terms: D000328:Adult; D000367:Age Factors; D002130:Calcium Phosphates / Q000378:metabolism; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000208:ethnology / Q000378:metabolism; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000208:ethnology / Q000378:metabolism; D006973:Hypertension / Q000150:complications / Q000208:ethnology / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000209:etiology / Q000628:therapy; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D015995:Prevalence; D044469:Racial Groups; D011994:Recombinant Proteins; D006435:Renal Dialysis; D013223:Statistics as Topic; D013997:Time Factors; D014508:Urea / Q000378:metabolism
chemical_list: D002130:Calcium Phosphates; D010281:Parathyroid Hormone; D011994:Recombinant Proteins; C485828:alpha-tricalcium phosphate; C485830:tetracalcium phosphate; D004921:Erythropoietin; C485838:calcium phosphate, monobasic, anhydrous; D014508:Urea; C020243:calcium phosphate; C485829:calcium phosphate, dibasic, anhydrous