BACKGROUND: Chronic kidney disease (CKD) is associated with mineral metabolism dysregulation, cardiovascular disease, and premature mortality. No study specifically examined mineral metabolism trends in a generalizable sample of patients at increased CKD risk. METHODS: This cross-sectional analysis from November 1, 2005, to December 31, 2006, of calcium, phosphorus, and parathyroid hormone (PTH) includes 2,646 individuals with estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m(2) in the National Kidney Foundation Kidney Early Evaluation Program (KEEP), a community-based health-screening program targeting individuals 18 years and older with diabetes, hypertension, or family history of kidney disease, diabetes, or hypertension. A parallel analysis of National Health and Nutrition Examination Survey (NHANES) 1999-2004 data was performed. RESULTS: In KEEP, as eGFR decreased from 55 to less than 60 mL/min/1.73 m(2) to less than 30 mL/min/1.73 m(2), calcium level decreased (9.55 +/- 0.47 to 9.34 +/- 0.62 mg/dL; P < 0.001), phosphorus level increased (3.70 +/- 0.59 to 4.15 +/- 0.80 mg/dL; P < 0.001), and PTH level increased (66.3 +/- 36.3 to 164 +/- 109 pg/mL; mean, 80.8 +/- 57.0 pg/mL; P < 0.001). NHANES 1999-2004 showed similar trends, with PTH values not as high. Individuals within opinion-based Kidney Disease Outcomes Quality Initiatives targets from the highest to the lowest eGFR group were as follows: calcium, 93.0% to 92.3% (KEEP) and 97.4% to 89.6% (NHANES); phosphorus, 90.4% to 90.3% (KEEP) and 91.6% to 87.1% (NHANES); and PTH, 46.1% to 31.2% (KEEP) and 56.4% to 36.1% (NHANES). CONCLUSIONS: In a community-based CKD screening population, increased PTH level occurs early in patients with stage 3, typically with normal calcium and phosphorus levels. These findings support the importance of including PTH with calcium and phosphorus monitoring for individuals with eGFR less than 60 mL/min/1.73 m(2).
BACKGROUND:Chronic kidney disease (CKD) is associated with mineral metabolism dysregulation, cardiovascular disease, and premature mortality. No study specifically examined mineral metabolism trends in a generalizable sample of patients at increased CKD risk. METHODS: This cross-sectional analysis from November 1, 2005, to December 31, 2006, of calcium, phosphorus, and parathyroid hormone (PTH) includes 2,646 individuals with estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m(2) in the National Kidney Foundation Kidney Early Evaluation Program (KEEP), a community-based health-screening program targeting individuals 18 years and older with diabetes, hypertension, or family history of kidney disease, diabetes, or hypertension. A parallel analysis of National Health and Nutrition Examination Survey (NHANES) 1999-2004 data was performed. RESULTS: In KEEP, as eGFR decreased from 55 to less than 60 mL/min/1.73 m(2) to less than 30 mL/min/1.73 m(2), calcium level decreased (9.55 +/- 0.47 to 9.34 +/- 0.62 mg/dL; P < 0.001), phosphorus level increased (3.70 +/- 0.59 to 4.15 +/- 0.80 mg/dL; P < 0.001), and PTH level increased (66.3 +/- 36.3 to 164 +/- 109 pg/mL; mean, 80.8 +/- 57.0 pg/mL; P < 0.001). NHANES 1999-2004 showed similar trends, with PTH values not as high. Individuals within opinion-based Kidney Disease Outcomes Quality Initiatives targets from the highest to the lowest eGFR group were as follows: calcium, 93.0% to 92.3% (KEEP) and 97.4% to 89.6% (NHANES); phosphorus, 90.4% to 90.3% (KEEP) and 91.6% to 87.1% (NHANES); and PTH, 46.1% to 31.2% (KEEP) and 56.4% to 36.1% (NHANES). CONCLUSIONS: In a community-based CKD screening population, increased PTH level occurs early in patients with stage 3, typically with normal calcium and phosphorus levels. These findings support the importance of including PTH with calcium and phosphorus monitoring for individuals with eGFR less than 60 mL/min/1.73 m(2).
Authors: Olivier Moranne; Marc Froissart; Jerome Rossert; Cedric Gauci; Jean-Jacques Boffa; Jean Philippe Haymann; Mona Ben M'rad; Christian Jacquot; Pascal Houillier; Benedicte Stengel; Bruno Fouqueray Journal: J Am Soc Nephrol Date: 2008-11-12 Impact factor: 10.121
Authors: Maurizio Gallieni; Nicola De Luca; Domenico Santoro; Gina Meneghel; Marco Formica; Giuseppe Grandaliano; Francesco Pizzarelli; Maria Cossu; Giuseppe Segoloni; Giuseppe Quintaliani; Salvatore Di Giulio; Antonio Pisani; Moreno Malaguti; Cosimo Marseglia; Lamberto Oldrizzi; Mario Pacilio; Giuseppe Conte; Antonio Dal Canton; Roberto Minutolo Journal: J Nephrol Date: 2015-05-19 Impact factor: 3.902
Authors: Georges Saab; Adam Whaley-Connell; Andrew Bombeck; Manjula Kurella Tamura; Suying Li; Shu-Cheng Chen; Samy I McFarlane; James R Sowers; Keith Norris; George L Bakris; Peter A McCullough Journal: Cardiorenal Med Date: 2011-04-15 Impact factor: 2.041
Authors: Rodrigo B Oliveira; Ana L E Cancela; Fabiana G Graciolli; Luciene M Dos Reis; Sérgio A Draibe; Lilian Cuppari; Aluizio B Carvalho; Vanda Jorgetti; Maria E Canziani; Rosa M A Moysés Journal: Clin J Am Soc Nephrol Date: 2009-11-12 Impact factor: 8.237