BACKGROUND: Parathyroid hormone (PTH) levels in African-American (AA) chronic kidney disease (CKD) patients exceed those in patients of other races; mechanisms are unknown. METHODS: We performed a cross-sectional analysis of initial laboratory data collected on 2028 CKD patients (505 AA) from US practices using a laboratory CKD service. Serum calcium (Ca), phosphorus (P), 25-hydroxyvitamin D (25-D) and plasma PTH levels were compared between the two groups. RESULTS: Mean PTH for AA exceeded PTH for non-AA in Stages 2-5 (P<0.001, all four stages). 25-D levels were higher for non-AA in Stages 1-3 (P<0.001). Serum Ca and P did not differ between groups at any stage. Full adjustment for these variables using multivariable generalized linear modeling did not remove the effect of AA race: AA PTH values exceeded non-AA values in CKD Stages 2-5 (P<0.02, all four stages). Serum Ca, P and 25-D were all inversely correlated with PTH levels irrespective of race, but all factors combined accounted for ∼42% of the variance in PTH. CONCLUSIONS: PTH rises with progressive CKD stage far more in AA than in non-AA patients, and only a moderate component of the rise in PTH is explained by changes in serum Ca, P and 25-D in either group. These findings concur with those from other large CKD cohorts and support the need for further study to determine other factors responsible for this racial difference.
BACKGROUND:Parathyroid hormone (PTH) levels in African-American (AA) chronic kidney disease (CKD) patients exceed those in patients of other races; mechanisms are unknown. METHODS: We performed a cross-sectional analysis of initial laboratory data collected on 2028 CKD patients (505 AA) from US practices using a laboratory CKD service. Serum calcium (Ca), phosphorus (P), 25-hydroxyvitamin D (25-D) and plasma PTH levels were compared between the two groups. RESULTS: Mean PTH for AA exceeded PTH for non-AA in Stages 2-5 (P<0.001, all four stages). 25-D levels were higher for non-AA in Stages 1-3 (P<0.001). Serum Ca and P did not differ between groups at any stage. Full adjustment for these variables using multivariable generalized linear modeling did not remove the effect of AA race: AA PTH values exceeded non-AA values in CKD Stages 2-5 (P<0.02, all four stages). Serum Ca, P and 25-D were all inversely correlated with PTH levels irrespective of race, but all factors combined accounted for ∼42% of the variance in PTH. CONCLUSIONS:PTH rises with progressive CKD stage far more in AA than in non-AA patients, and only a moderate component of the rise in PTH is explained by changes in serum Ca, P and 25-D in either group. These findings concur with those from other large CKD cohorts and support the need for further study to determine other factors responsible for this racial difference.
Authors: Sharon M Moe; Leah Wetherill; Brian Scott Decker; Dongbing Lai; Safa Abdalla; Jin Long; Matteo Vatta; Tatiana M Foroud; Glenn M Chertow Journal: Clin J Am Soc Nephrol Date: 2017-06-19 Impact factor: 8.237
Authors: Jin Xia; Wanzhu Tu; JoAnn E Manson; Hongmei Nan; Aladdin H Shadyab; Jennifer W Bea; Ting-Yuan D Cheng; Lifang Hou; Yiqing Song Journal: Am J Clin Nutr Date: 2020-08-01 Impact factor: 7.045
Authors: Julia J Scialla; Rulan S Parekh; Joseph A Eustace; Brad C Astor; Laura Plantinga; Bernard G Jaar; Tariq Shafi; Josef Coresh; Neil R Powe; Michal L Melamed Journal: Am J Nephrol Date: 2015-08-20 Impact factor: 3.754