Chinese Journal of Blood Purification ›› 2020, Vol. 19 ›› Issue (01): 17-20.doi: 10.3969/j.issn.1671-4091.2020.01.005

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The effect of baseline parathyroid hormone level on the prognosis of peritoneal dialysis patients

  

  1. 1Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2019-09-20 Revised:2019-11-19 Online:2020-01-20 Published:2019-12-30

Abstract: 【Abstract】Objective The purpose of this study was to investigate the changes of serum intact parathyroid hormone (iPTH) and its related factors in incident peritoneal dialysis (PD) patients, and to assess its impact on long-term survival of PD patients. Methods Clinical data were analyzed for all adult chronic renal failure patients initiating PD therapy. According to the iPTH level, patients were divided into four groups: group A (iPTH <150pg/ml), group B (iPTH 150~300pg/ml), group C (iPTH 300~ 600 pg/ml), and group D (iPTH ≥600pg/ml). Variance analysis and χ2 test were used to compare the clinical and laboratory data of the four groups. Multiple linear regression was used to screen the risk factors for baseline iPTH level. Cox regression model was used to analyze the factors for survival rate. Kaplan-Meier survival analysis and Cox regression model were used to compare the survival rate of the four groups. Results This study enrolled 222 patients, in which baseline iPTH <150 pg/ml accounted for 43.7% of the patients. The patients with baseline iPTH <150 pg/ml had the characteristics of older age (F=6.235, P<0.001), higher incidence of diabetes mellitus (F=16.277, P=0.001), more complications (F=4.348, P=0.005), and higher eGFR (F= 5.699, P=0.001). However, multiple linear regression revealed that only age (β =- 8.700, P<0.001) and diabetes mellitus
(β=145.400, P=0.012) had the independent effects on baseline iPTH level. Kaplan- Meier survival curve showed that the survival rate was different among the four groups (P=0.002). Multivariate COX regression showed that only age (β=0.066, P< 0.001) was the independent risk factor for predicting mortality, and baseline iPTH level (P=0.507) could not independently predict mortality. Conclusion The incident PD patients with older age and diabetes mellitus were more likely to have lower baseline iPTH. However, baseline iPTH level could not independently predict mortality.

Key words: Peritoneal dialysis, Intact parathyroid hormone, Survival rate, Mineral and bone disorder

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