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Correlation Between Serum Parathyroid Hormone and Markers of Bone Metabolism in Hemodialysis Patients



Atapour A1 ; Mirmohammad Sadeghi H2 ; Mahboobnia K3 ; Pourfarzam M3
Authors
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Authors Affiliations
  1. 1. Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Biotechnology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Isfahan Medical School Published:2013

Abstract

Background: Renal osteodystrophy is a common finding in patients with chronic kidney disease (CKD) requiring dialysis (stages 3-5). Increased serum activity of bone isoform alkaline phosphatase is a good marker for investigating uremic osteodystrophy in these patients. Considering the important effect of vitamin D on calcium, mineral homeostasis and parathyroid hormone (PTH), the objective of this study was investigation of association between serum levels of PTH, 25(OH)D3, Alkaline phosphatase (ALP), calcium (Ca) and inorganic phosphate (Pi) in hemodialysis patients. Methods: Ninety hemodialysis patients were included in this study. Mean age of the patients was 36.0 ± 11.4 years and duration of receiving dialysis was 2 months to 23 years (Mean ± SD: 80 ± 71 months). The serum levels of 25(OH)D3, ALP, Ca and Pi and PTH were measured. Data analysis was performed using SPSS software. Findings: Abnormal levels of serum Ca and Pi were more common in men than women (Ca: 63.6% versus 52.8%, Pi: 72.7% versus 50%, in men and women respectively); but more women had abnormal serum levels of ALP, PTH and vitamin D compared to men (ALP: 75% versus 54.5%, PTH: 97.2% versus 94.5%, 25(OH) D3: 63.9% versus 32.7%, in women and men respectively). Statistical correlation between serum levels of ALP and PTH (P = 0.0500), PTH and hemodialysis duration (r = 0.588, P < 0.0005) were significant. No statistically significant correlation was observed between serum levels of PTH and other biochemical factors. Conclusion: In the majority of studied patients, the serum Pi and PTH levels were out of normal ranges that indicate poor management of hyperparathyroidism and Pi in these patients. According the results of this study, the intensity of secondary hyperparathyroidism and its deleterious effects on bone tissue was more common in women than men.
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