title: Secondary hyperparathyroidism prevalence and profile, between diabetic and non-diabetic patients with stage 3 to 4 chronic kidney disease attended in internal medicine wards. MiPTH study.
abstract: OBJECTIVE
  Secondary hyperparathyroidism (SHPTH) is a leading cause of renal osteodystrophy, and an independent risk factor for all-cause and cardiovascular mortality. Our aim is to establish differences in prevalence and profile of SHPTH, regarding diabetics or non-diabetics with chronic kidney disease (CKD).
  
  
  METHODS
  Cross-sectional multicenter study which included patients with stages 3 to 4 CKD. SHPTH was considered when the intact PTH levels (iPTH) were equal or higher than 70pg/ml. We divided the sample into two groups (diabetics and non-diabetics). We used robust statistical methods.
  
  
  RESULTS
  409 patients (214 diabetics) were studied. HPTH was found in 60.4% of diabetics vs 65% of non-diabetics (P=0.42). Diabetics with HPTH were younger (79.5 vs 82.3 years-old, P=0.005), and had more hypertension (P=0.0014), dyslipidemia (P=0.0001) and comorbidities. In multivariate analysis, we found a significant relationship in case of diabetics, with age (OR: 1.04, 95%CI 1.005-1.09 P=0.02 ), and with statins treatment (OR 2.3, 95%CI 1.17-4.54, P=0.01).
  
  
  CONCLUSIONS
  The prevalence of SHPTH between the groups was similar, however, diabetics had more presence of hypertension and dyslipidemia, and SHPTH in this case was also related with moderate microalbuminuria and lower levels of vitamin D. An association with statins was also found in this group.
authors.affiliation: Internal Medicine Department, Zafra County Hospital, Badajoz, Spain. Electronic address: joscarlor@gmail.com.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Arévalo-Lorido
authors.affiliation: Internal Medicine Department, Zafra County Hospital, Badajoz, Spain.
authors.forename: Juana
authors.initials: J
authors.lastname: Carretero-Gómez
authors.affiliation: Internal Medicine Department, "Virgen del Puerto" Hospital, Plasencia, Cáceres, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: García-Sánchez
authors.affiliation: Internal Medicine Department, "Perpétuo Socorro" University Hospital, Badajoz, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Maciá-Botejara
authors.affiliation: Internal Medicine Department, "Ciudad de Coria" Hospital, Cáceres, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Ramiro-Lozano
authors.affiliation: Internal Medicine Department, Don Benito-Villanueva Hospital, Badajoz, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Masero-Carretero
authors.affiliation: Nephrology Department, "Infanta Cristina" University Hospital, Badajoz, Spain.
authors.forename: Nicolás Roberto
authors.initials: NR
authors.lastname: Robles
authors.affiliation: Internal Medicine Department, "Infanta Cristina" University Hospital, Badajoz, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Bureo-Dacal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000378:metabolism / Q000503:physiopathology*; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006961:Hyperparathyroidism / Q000453:epidemiology*; D006973:Hypertension / Q000150:complications; D008297:Male; D015999:Multivariate Analysis; D010281:Parathyroid Hormone / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000378:metabolism; D013030:Spain / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010281:Parathyroid Hormone
keywords: Chronic kidney disease; Diabetes mellitus; Secondary hyperparathyroidism