Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study

Abstract

Backgroud : Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods : We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH<150pg/mL; middle-PTH group, PTH=150-300pg/mL; high-PTH group, PTH>300pg/mL. Results : During a median follow-up of 29.5 (interquartile range 16-49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Low PTH levels were associated with older age, higher calcium levels and lower alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014-2.663, P=0.044]. Conclusions: Low PTH levels are independently associated with peritonitis in incident PD patients.

Relationship of Neutrophil Lymphocyte Ratio (NLR) with Parathyroid Hormone (PTH) in Maintenance Hemodialysis Patients

“…However there are also a few recent papers that have shown association of PTH with resolution of inflammation and healing in several contexts e.g. peritonitis [24] and periodontitis [25,26]. Low serum PTH level has been shown to be a predictor of infection-associated mortality in incident dialysis patients-both hemodialysis as well as peritoneal dialysis [27] Age, Gender, Sugar etc.…”