title: Race is a major determinant of secondary hyperparathyroidism in uremic patients: comparative study of Blacks and Hispanics.
abstract: BACKGROUND
  Racial differences in bone and mineral metabolism are characterized by higher circulating intact parathyroid hormone levels (iPTH) in Black vs. White patients with end-stage renal disease (ESRD). The susceptibility of Hispanic patients to secondary hyperparathyroidism is not known.
  
  
  METHODS
  This is a cross-sectional study that compares bone and mineral parameters of 48 Black and 61 Hispanic ESRD patients attending a single outpatient hemodialysis center.
  
  
  RESULTS
  The mean iPTH level was significantly higher in Blacks vs. Hispanics, despite similar levels of serum bone-specific alkaline phosphatase (BSAP), calcium, phosphorus and similar dosages of vitamin D analogs. After adjusting for independent variables including age, diabetic status and plasma levels of C-reactive protein, phosphorus and albumin significant predictors of iPTH were race (p < 0.01), gender (p < 0.05), serum calcium (p < 0.05), BSAP (p < 0.0001) and doses of vitamin D analogs (p < 0.001). Adjusted predictors of serum BSAP were PTH (p < 0.0001), gender (p = 0.01) and serum albumin (p < 0.005), but not race. There was no significant difference in serum BSAP between Blacks and Hispanics despite 60% higher iPTH levels in Blacks.
  
  
  CONCLUSIONS
  Amongst ESRD patients, Blacks have higher iPTH levels compared with Hispanics despite similar BSAP levels, these finding support the emerging evidence of racial/ethnic differences in response of bone to PTH action.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Charles Drew University of Medicine and Sciences, Los Angeles, CA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Omije
authors.forename: K
authors.initials: K
authors.lastname: Norris
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.forename: D
authors.initials: D
authors.lastname: Pan
authors.forename: D
authors.initials: D
authors.lastname: Kermah
authors.forename: A
authors.initials: A
authors.lastname: Gupta
mesh_terms: D001741:Black or African American; D015519:Bone Density; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000208:ethnology* / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D014511:Uremia / Q000150:complications* / Q000208:ethnology*
chemical_list: D010281:Parathyroid Hormone; D012709:Serum Albumin; D010758:Phosphorus