Secondary hyperparathyroidism among end-stage renal disease patients in Beharlou hospital, Tehran province, Iran

Abstract

Introduction: The importance of secondary hyperparathyroidism (SHPT) are frequently neglected in hemodialysis (HD) centers. Objectives: The aim of this study is to determine the prevalence of SHPT in a group of ESRD patients under routine HD. Patients and Methods: From May 2016 to August 2016, this cross sectional study was conducted on ESRD patients undergoing HD in our HD center in Beharlou hospital, Tehran province, Iran. Blood samples were obtained prior to HD session to assess laboratory parameters including intact PTH level, serum calcium, phosphorus, and alkaline phos phatase. Immunoradiometric assay was used to measure serum intact PTH (iPTH) level. Results: Forty-five HD patients, including 19 females (42.2%) with mean age of 60±14.3 years were enrolled to the study. According to the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines for mineral metabolism, 60% of our patients (n = 27) had accepted normal range of serum calcium (8.4 to 9.5 mg/dL) while 28.9% of patients had serum calcium of below 8.4 mg/dL. Around 60% of our patients (n = 27) had accepted normal range of serum phosphorus (3.5 to 5.5 mg/dL) while serum phosphorus above 5.5 mg/dL was detected in 31.1% of HD patients. Sixteen patients (35.55%) had iPTH lev els between 150-300 ρg/mL which was in the accepted ranges for iPTH lev els among HD patients. Seventeen patients (37.78%) had iPTH lev els above accepted range. Conclusion: This study showed that PTH abnormalities and disorders of mineral metabolism are common among patients with ESRD. It is crucial to better understand the pathogenesis and treatment of these disorders among ESRD patients.

Role of Melatonin in Angiotensin and Aging

“…Early-stage CKD patients have been reported to have increased oxidation of DNA, proteins, and lipids, which may contribute to organ damage [ 99 ]. The disease progress of CKD is associated with increased OS and inflammation, which promotes the buildup of uremic toxins that exacerbates renal failure [ 100 , 101 ]. CKD patients undergoing hemodialysis are also at a greater risk of inflammation and mortality [ 102 ].…”