Endocrine Abstracts

Introduction and objectives: The aim of this study was to evaluate the risk of death in relation to hemodialysis.

Material and methods: We performed a 10-month follow up study of hemodialysed patients attending our Center. A total of 97 patients were evaluated: 37 (38.1%) nephroangiosclerosis, 28 (28.9%) diabetic nephropathy, 18 (18.6%), and glomerulonephritis 14 (14.4%) other causes. Somatic sensory neuropathy (PN) was documented using the Neuropathy Disability Score (NDS), vibration perception threshold (VPT) was measured by semiquantitative tuning fork C128 (grades 0–8) and AR (ankle jerk reflex) were recorded.

Results: Thirteen patients died (13.4%), 12 from the first two groups, none of the third group. Patients who died of other differed by: age (64.2±11.2 vs 55±12.9 years, P 0.02), CRP (13.7±10.5 vs 7.2±8.8 mg/l, P 0.03), BMI high (32.8±6.5 vs 29.3±5.9, P 0.06), AR (3.5±0.9 vs 2.3±1.8, P 0.02), NDS (5.8±2.7 vs 3.8±3.2, P 0.03), albumin level (34.7±5.1 vs 38±2.9 g/l, P 0.06), duration of dialisys (2.3±2.3 vs 5.2±4.9 years, P 0.04), and VPT (3±3.2 vs 5.1±2.5, P 0.001). There were no differences in parathormon (PTH) between groups (180.9±264 vs 318±498 pg/ml, P 0.42). Simple regression analysis of NDS of the whole 97 patients: HDL chol (r +0.23, P 0.04), Hb (r −0.20, P 0.05), BG (blood glucose; r +0.37, P 0.0003), PTH (r −0.21, P 0.047), creatinine (r −0.30, P 0.003), duration of dialisys (r −0.34, P 0,000), ABPI (ankle brachial pressure index, r +0.20, P 0.02). In multiple regression model as a significant deterioration of neuropathy (NDS) remains only: body height (P 0.005), blood glucose (P 0.08) and PTH (P 0.04).

Conclusions: This study showed that PN was a prognostic factor for death in dialysed patients and its failure was associated with elevated BG and lower PTH. So, the treatment of secondary hyperparathyreoidism in hemodialysed patient is not indicated in at least those patient with developed peripheral neuropathy.