The Association between Parathyroid Hormone Levels and the Cardiorenal Metabolic Syndrome in Non-Diabetic Chronic Kidney Disease

Abstract

Aims: The relationship between parathyroid hormone (PTH) and the cardiorenal metabolic syndrome was examined among non-diabetic persons with chronic kidney disease (CKD). Methods: In a cross-sectional analysis, the relationship between PTH levels and the cardiorenal metabolic syndrome was investigated in 3,215 non-diabetic participants in the National Kidney Foundation-Kidney Early Evaluation Program (KEEP 2.0) found to have CKD (eGFR <60 ml/min/1.73 m²). Results: In unadjusted analyses, the prevalence of the cardiorenal metabolic syndrome increased along increasing PTH quartiles (31.7, 33.8, 37.3, and 48.7%, respectively, p for trend <0.0001). After multivariate adjustment, as compared to the first PTH quartile, odds of the cardiorenal metabolic syndrome were 16% (p = 0.18), 35% (p = 0.006), and 80% (p < 0.0001) higher for the second, third, and fourth quartiles, respectively. When taken as a continuous predictor, each standard deviation increase of natural log transformed PTH was associated with 26% (p < 0.0001) higher odds of the cardiorenal metabolic syndrome. The association of PTH with the cardiorenal metabolic syndrome was not modified by age or gender (p for interaction was not significant for both modifiers). Conclusions: Among an outpatient non-diabetic population with CKD, higher PTH levels were associated with a higher prevalence of the cardiorenal metabolic syndrome.

The Association between Parathyroid Hormone Levels and Hemoglobin in Diabetic and Nondiabetic Participants in the National Kidney Foundationʼs Kidney Early Evaluation Program

“…The KEEP database from November 1, 2005 through December 11, 2010 was examined. Since PTH levels were only measured among those with an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m 2 [18,19], the analysis was limited to this eGFR range among those with PTH and hemoglobin values recorded. Therefore, a total of 10,750 participants were included in this analysis.…”

“…Calcium, phosphorus, and intact PTH were measured as previously described [18,19]. Specifically, PTH was analyzed using the Immulite 2000 analyzer (Siemens Medical Solutions Diagnostics, www.usa.siemens.com).…”

Fibroblast Growth Factor 23 and Hypophosphatemia: A Case of Hypophosphatemia along the Rickets-Osteomalacia Spectrum

“…An important evolving concept incorporates deranged phosphate metabolism in the pathogenesis of abnormalities characterizing the cardiorenal syndrome [12,19,20]. The current case report illustrates how abnormal phosphate metabolism can lead to systemic multiple organ disease including bone disease.…”

Moderators of the Association Between Serum Parathyroid Hormone and Metabolic Syndrome in Participants with Elevated Parathyroid Hormone: NHANES 2003–2006

“…PTH also was found to be associated with MetS in other specific populations identified by diagnosis, age, gender or ethnicity. In one study, non-diabetic outpatients with chronic kidney disease (CKD) were associated with a higher prevalence of cardio-renal metabolic syndrome, and the prevalence of MetS increased as PTH increased, without associations with age or gender [22]. In a study of older American men, an inverse relationship was found between 25(OH)D and MetS, independent of Kalzium intake and PTH concentrations; in this population, as with the non-diabetic outpatients above, the odds for MetS increased as PTH increased.…”