Serum Intact Parathyroid Hormone Level is Inversely Correlated with Glycated Haemoglobin in Diabetic Chronic Kidney Disease Stages 3-5 Predialysis Patients

Haque, Wasim Md Mohosin Ul; Rahim, Muhammad Abdur; Mitra, Palash; Samad, Tabassum; Habib, Samira Humaira; Iqbal, Sarwar

doi:10.3329/birdem.v7i2.32447

Cited by 1 publication

(1 citation statement)

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“…Ismail-Beigi et al (19) considered hyperglycaemia as an independent risk factor of DN with an inverse correlation between glycaemic control and progression of DN. On the other hand, Ali et al (20) and Haque et al (21) reported lowered intact PTH level with poor glycaemic control during moderate and advanced stages of DN. This inconsistency was attributed to the divergent pathogenesis of CKD-MBD with elevated PTH during high bone turn-over stage and lowered PTH accompanying a dynamic bone disease stage.…”

Section: Discussionmentioning

confidence: 99%

Albuminuria Independently Determines Intact Parathyroid Hormone in Diabetic Nephropathy with Micro-albuminuria

Gameil

Marzouk²,

Elsebaie³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Diabetes mellitus (DM) is a well-recognised cause of end-stage renal disease (ESRD) through diabetic nephropathy (DN). Elevated intact parathyroid hormone (intact PTH) in DN represents a serious metabolic threat. Objective: We aimed to detect determinants of intact PTH changes during micro-albuminuria stage of DN. Patients and Methods: An observational study included 294 patients with type 2 diabetes mellitus (T2D) divided into 2 groups. Case group; 220 patients of DN with micro-albuminuria versus control group; 74 patients without albuminuria. Participants were subjected to history taking, clinical examination and laboratory assessment of glycosylated haemoglobin (HBA1c), serum creatinine, blood urea nitrogen (BUN), urine albumin creatinine ratio (urine ACR), estimated glomerular filtration rate (eGFR), 25(OH) vitamin D, intact PTH, serum ionized calcium, phosphorus and magnesium. Results: Among 220 patients of mean age 48.7 years and 57.7% male, albuminuria was significantly higher (P<0.001). We found non-significant difference between the study groups in estimated glomerular filtration rate (eGFR) and serum creatinine (P=0.375 and 0.294) respectively. Meanwhile, intact PTH was significantly elevated (P<0.001) in case group. Intact PTH was positively correlated with urine ACR, HBA1c, BUN, and serum creatinine and inversely correlated with eGFR. However, urine ACR was the only independent determinant of intact PTH in diabetic patients with micro-albuminuria (OR: 1.177; 95% CI: 1.074-1.290, P= 0.001). Conclusion: Interestingly, urine albumin creatinine ratio was the only independent determinant of intact PTH in diabetic patients with micro-albuminuria.

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Section: Discussionmentioning

confidence: 99%