Effects of diabetes mellitus, age, and duration of dialysis on parathormone in chronic hemodialysis patients.

Secondary hyperparathyroidism (SHPTH) can develop early in the course of chronic renal failure and becomes more prominent as kidney function declines. We studied the effect of diabetes, age, and dialysis on parathyroid function in 60 (21 women, 39 males; 44 non-diabetic, 16 diabetic) hemodialysis (HD) patients. Serum intact PTH (iPTH), calcium, phosphorus, alkaline phosphatase (ALP), and magnesium (Mg) were measured. Adequacy of HD was evaluated by calculating the urea reduction rate (URR). There were significantly lower values of serum iPTH, ALP, and dialysis adequacy among diabetic than non-diabetes HD patients. In addition, there were an inverse correlation of age and serum iPTH (r= -0.27, p=0.034) as well as age and serum phosphorus (r= -0.28, p=0.031). There was also a positive correlation between serum iPTH with the duration (r=0.001, p=0.42) and doses of dialysis treatment (r=0.38, p=0.002). We conclude that a significant negative correlation between age and serum phosphorus and lower parathyroid activity in diabetic HD patients, which implies more prevalence of bone disease in elderly diabetic HD patients. Further study of bone disease in this group of patients is required to evaluate its effect on outcome and different therapeutic interventions.