José Carlos Arévalo-Lorido1, Juana Carretero-Gómez2, Francisco García-Sánchez3, Enrique Maciá-Botejara4, José Manuel Ramiro-Lozano5, Antonio Masero-Carretero6, Nicolás Roberto Robles7, Juan Carlos Bureo-Dacal8. 1. Internal Medicine Department, Zafra County Hospital, Badajoz, Spain. Electronic address: joscarlor@gmail.com. 2. Internal Medicine Department, Zafra County Hospital, Badajoz, Spain. 3. Internal Medicine Department, "Virgen del Puerto" Hospital, Plasencia, Cáceres, Spain. 4. Internal Medicine Department, "Perpétuo Socorro" University Hospital, Badajoz, Spain. 5. Internal Medicine Department, "Ciudad de Coria" Hospital, Cáceres, Spain. 6. Internal Medicine Department, Don Benito-Villanueva Hospital, Badajoz, Spain. 7. Nephrology Department, "Infanta Cristina" University Hospital, Badajoz, Spain. 8. Internal Medicine Department, "Infanta Cristina" University Hospital, Badajoz, Spain.
Abstract
AIMS: Secondary hyperparathyroidism (SHPTH) is a leading cause of renal osteodystrophy, and an independent risk factor for all-cause and cardiovascular mortality. Our aim is to establish differences in prevalence and profile of SHPTH, regarding diabetics or non-diabetics with chronic kidney disease (CKD). METHODS: Cross-sectional multicenter study which included patients with stages 3 to 4 CKD. SHPTH was considered when the intact PTH levels (iPTH) were equal or higher than 70pg/ml. We divided the sample into two groups (diabetics and non-diabetics). We used robust statistical methods. RESULTS: 409 patients (214 diabetics) were studied. HPTH was found in 60.4% of diabetics vs 65% of non-diabetics (P=0.42). Diabetics with HPTH were younger (79.5 vs 82.3 years-old, P=0.005), and had more hypertension (P=0.0014), dyslipidemia (P=0.0001) and comorbidities. In multivariate analysis, we found a significant relationship in case of diabetics, with age (OR: 1.04, 95%CI 1.005-1.09 P=0.02 ), and with statins treatment (OR 2.3, 95%CI 1.17-4.54, P=0.01). DISCUSSION: The prevalence of SHPTH between the groups was similar, however, diabetics had more presence of hypertension and dyslipidemia, and SHPTH in this case was also related with moderate microalbuminuria and lower levels of vitamin D. An association with statins was also found in this group.
AIMS: Secondary hyperparathyroidism (SHPTH) is a leading cause of renal osteodystrophy, and an independent risk factor for all-cause and cardiovascular mortality. Our aim is to establish differences in prevalence and profile of SHPTH, regarding diabetics or non-diabetics with chronic kidney disease (CKD). METHODS: Cross-sectional multicenter study which included patients with stages 3 to 4 CKD. SHPTH was considered when the intact PTH levels (iPTH) were equal or higher than 70pg/ml. We divided the sample into two groups (diabetics and non-diabetics). We used robust statistical methods. RESULTS: 409 patients (214 diabetics) were studied. HPTH was found in 60.4% of diabetics vs 65% of non-diabetics (P=0.42). Diabetics with HPTH were younger (79.5 vs 82.3 years-old, P=0.005), and had more hypertension (P=0.0014), dyslipidemia (P=0.0001) and comorbidities. In multivariate analysis, we found a significant relationship in case of diabetics, with age (OR: 1.04, 95%CI 1.005-1.09 P=0.02 ), and with statins treatment (OR 2.3, 95%CI 1.17-4.54, P=0.01). DISCUSSION: The prevalence of SHPTH between the groups was similar, however, diabetics had more presence of hypertension and dyslipidemia, and SHPTH in this case was also related with moderate microalbuminuria and lower levels of vitamin D. An association with statins was also found in this group.