Endocrine Abstracts

Introduction: Parathyroid hormone (PTH) starts to rise very early in the course of kidney disease. As kidney disease progresses, plasma levels of vitamin D and calcium begin to decline, thus contributing to greater secretion of PTH. In addition, the retention of phosphate further increases PTH secretion independent of calcium and vitamin D levels. Continued stimulation of PTH secretion leads to irreversible parathyroid gland hyperplasia.

Objectives: To measure the PTH levels in hemodialysis patients and relate with the duration of hemodialysis.

Methods: Forty-two stable hemodialysis patients, 22 (52.4%) women and 20 (47.6%) men with a mean age of 66.1±10.7 of years were included in the study. The average duration of hemodialysis was 2–13 years, with two or three dialysis session per week.

Blood samples were obtained prior to a dialysis session, after an overnight fast. The serum PTH concentrations were determined using an immunoreactive measuring (Elecsys, Roche).

Results: Six (14.3%) patients exhibited elevated PTH levels (>250 pg/ml).

– in two patients the duration of hemodialysis was 13 years

– in two patients was 8 years

– in one patient was 6 years and

– in one patient was 5 years.

The PTH level was positively correlated with the duration of hemodialysis.

Conclusion: PTH is the major determinant of rates of bone remodeling and turnover in hemodialysis patients with end-stage renal disease; accurate assessments of plasma PTH levels are essential not only for estimating the bone metabolism of renal osteodystrophy but also for appropriately monitoring the treatment of secondary hyperparathyroidism.