Glycaemic control and serum intact parathyroid hormone levels in diabetic patients on haemodialysis therapy

Murakami, Reiichi; Murakami, Shuichi; R, Tsushima; Ueda, Chiyuki; Mikami, Kyoko; Ebina, Takanori; Kumasaka, Ryuichiro; Nakamura, Norio; Okumura, Ken

doi:10.1093/ndt/gfm639

Cited by 26 publications

(17 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results were supported previously by Murakami et al, [10], who reported that there was an inverse correlation betweenserum iPTH levels and glycemic control. Specifically, diabetic patients with poor glycemic control were characterized by low circulating iPTH, which is conversely found at higher levels in diabetic patients with good glycemic control.…”

supporting

confidence: 91%

“…High Turnover Bone Disease (HTBD) due to high iPTH level and Low Turnover Bone Disease (LTBD) due to comparatively low iPTHlevel [7]. It has been revealed in some studies that, usually diabetic ESRD patients on MHD have lower iPTH level than non-diabetic ESRD patients on MHD [8][9][10].Increasing evidence suggests that,in both diabetic and non-diabetic haemodialyzed patients, impaired iPTH secretion appears to be the main determinant responsible for decreased bone turnover and 'adynamic bone disease [11].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Functional Hypoparathyroidism Among Type 2 Diabetic Patients on Hemodialysis: Impact of Glycemic Control.

Hassaan.¹,

Rashad²,

Hammam.³

et al. 2017

IJAR

View full text Add to dashboard Cite

Background:End-stage renal disease has become a public health concern worldwide. Type 2 diabetes is associated with significantly accelerated rates of diabetic nephropathy. There are controversies about the role of intact parathyroid hormone (iPTH) in the pathogenesis of osteodystrophy among diabetic patients on regular hemodialysis. We aimed to estimate serum levels of iPTH, 25-hydroxyvitamin D and to clarify the possible relationships between iPTH and HbA1c ;which reflect the glycemic control as well as other clinical and biochemical parameters in end-stage renal disease patients on regular hemodialysis. Subjects and methods: A case-control study of 84end-stage renal disease patients on maintenance hemodialysis thrice weekly.Patients were stratified into three groups;group1:28 diabetic patients with good glycemic control(HbA1c < 7), group 2:28 diabetic patients with poor glycemic control(HbA1c >7), and group3:28non diabetic patients, In all studied participants,blood urea, serum creatinine , calcium, phosphorus, albumin, alkaline phosphatase, lipid profile, HbA1c, fasting blood glucose (FBG),post prandial blood glucose (PPBG) and25-hydroxyvitamin Dwere measured.Also, we estimate serum iPTHlevels by ADVIA CENTAUR instrument using Chemiluminescence principle. Results:Non diabetic patienton chronic hemodialysis had significantly higher values of serum 25-hydroxyvitamin D,serum iPTHmore than diabetic group, moreover diabetic patients with poor glycemic control had significantly lower values of serum 25-hydroxyvitamin D and serum iPTH, compared to good glycemic control.In diabetic patients with poor glycemic control,iPTHlevel was negatively correlated with Alkaline phosphatase,post prandial blood glucose, fasting blood glucose, as well as HbA1c. In patients with good glycemic control serum iPTHlevel was positively correlated with25-hydroxyvitamin D., there were significant negative correlations betweeniPTH level and creatinine, alkaline phosphatase, phosphorous, albumin, post prandial blood glucose, fasting blood glucose, as well as HbA1c.Stepwise linear regression analysis showed that, serum iPTH levels were independently correlated with 25-hydroxyvitamin D with diastolic blood pressure,

show abstract

supporting

confidence: 91%

mentioning

confidence: 99%

Functional Hypoparathyroidism Among Type 2 Diabetic Patients on Hemodialysis: Impact of Glycemic Control.

Hassaan.¹,

Rashad²,

Hammam.³

et al. 2017

IJAR

View full text Add to dashboard Cite

show abstract

“…Prevalence of T-score ≤ -2.5 SD in the area of the proximal femur and/or at the lumbar spine in the age group over 50 years. Poor glycaemic control in diabetic hemodialysis patients is associated with lower PTH values compared to diabetic hemodialysis patients with good control 14 . We identified significant differences in values of residual renal function between female and male patients, as well as between non-diabetic and diabetic patients.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of biochemical markers and bone mineral density in patients with chronic kidney disease stage 5D at the start of hemodialysis treatment

Valkovský¹,

R²,

Tvrdík³

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Background. Patients with chronic kidney disease (CKD) have significant disorders of bone and mineral metabolism. In addition, they can also develop other bone disorders including osteoporosis. This study evaluated the bone mineral density (BMD) of patients at the start of hemodialysis treatment as well as the relationship between BMD and possible risk factors or biochemical markers. Methods. The study was performed in 82 patients (28 females, 54 males). BMD was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and the proximal femur. Results. We found a high prevalence of 25-hydroxyvitamin D deficiency (96%; mean levels 30.0 ± 17.7 nmol/L) and a reduction of BMD in comparison with gender-and age-matched normal population values at the total hip (Z-score = -0.31 ± 1.11) and the femoral neck (Z-score = -0.48 ± 1.16), but not at the lumbar spine (Z-score = 0.68 ± 1.81). The prevalence of T-scores ≤ -2.5 SD in the group of patients over 50 years was 52.0% in females and 33.3% in males. BMD positively correlated: with male gender and calcium levels at all measured sites, with age at the lumbar spine and with weight or BMI at the proximal femur. Conclusion. CKD patients at the start of hemodialysis treatment had a high prevalence of low T-score values, corresponding to values for osteoporosis in the general population. BMD at the proximal femur was below the expected average for age and gender, but at the lumbar spine, BMD in hemodialysis patients was above average in persons without known CKD.

show abstract

“…It is known that hemodialysis patients with diabetes mellitus (DM) are often characterized by a reduced bone remodeling and relative hypoparathyroidism (19). Poor glycemic control in hemodialysis patients with DM is associated with lower iPTH levels (20).…”

Section: Mean ± Sd T (Fn) T (Th) T (Ls)mentioning

confidence: 99%

Bone mineral density and bone metabolism biochemical markers in patients with chronic kidney disease at the hemodialysis treatment

Tamadon¹,

Moghimi²,

Semnani³

2017

J Parathyr Dis

View full text Add to dashboard Cite

Introduction: Chronic kidney disease (CKD) is associated with bone and mineral metabolism disorders. Objectives: This study investigated the bone mineral density (BMD) and bone metabolism biochemical markers in patients with CKD at the hemodialysis treatment among Iranian adults as well as the relationship between possible risk factors or biochemical markers with BMD. Patients and Methods:In this cross-sectional study, 77 patients with CKD stage 5D at the hemodialysis treatment were selected from September 2016 to February 2016. BMD was measured by dual-energy X-ray absorptiometry (DEXA) at the anteroposterior lumbar spine (LS) (L1-L4) and left proximal femur. Biochemical markers including calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), serum specific alkaline phosphatase (serum AP) and 25-hydroxy-vitamin D (25hD) were used for the prediction of BMD loss. Results: Two (2.6%) patients had normal levels of 25hD (mean levels 17.67 ± 11.66 µg/L). We found a reduction of BMD in comparison with age-and gender-matched normal population values at the femoral neck (FN) (T-score = -1.92 ± 1.29), at the total hip (TH) (T-score = -1.79 ± 1.25) and at the LS (T-score = -1.55 ± 1.84). The prevalence of T-scores ≤-2.5 SD was 28.6%, 35.1% and 13.0% according to the LS, FN and three bone sites T scores respectively. BMD negatively correlated with age at the proximal femur, with serum AP at the LS and with age of menopause at the FN. Conclusions:Patients with CKD at the hemodialysis treatment had a high prevalence of osteoporosis in the general population. BMD at the all bone sites was below the expected average for gender and age. Keywords: Bone mineral density, Chronic kidney disease, Hemodialysis, Biochemical markers, Osteoporosis Please cite this paper as: Tamadon MR, Moghimi J, Semnani V. Metabolic bone disease in end-stage renal disease patients under regular hemodialysis. J Parathyr Dis. 2018;6(2):50-56.

show abstract

Glycaemic control and serum intact parathyroid hormone levels in diabetic patients on haemodialysis therapy

Abstract: The status of glycaemic control in diabetic haemodialysis patients affects the serum iPTH levels. Good glycaemic control should be required to prevent osteodystrophy.

Cited by 26 publications

References 20 publications

Functional Hypoparathyroidism Among Type 2 Diabetic Patients on Hemodialysis: Impact of Glycemic Control.

Functional Hypoparathyroidism Among Type 2 Diabetic Patients on Hemodialysis: Impact of Glycemic Control.

Evaluation of biochemical markers and bone mineral density in patients with chronic kidney disease stage 5D at the start of hemodialysis treatment

Bone mineral density and bone metabolism biochemical markers in patients with chronic kidney disease at the hemodialysis treatment

Contact Info

Product

Resources

About