Eduardo J Duque, Maria Eugenia F Canziani, Ana Beatriz L Barra, Maria A Dalboni, Jorge P Strogoff-de-Matos, Rosilene M Elias, Rosa M A Moysés
{"title":"血液透析第一年的血清甲状旁腺激素轨迹：严重甲状旁腺功能亢进的路线图。","authors":"Eduardo J Duque, Maria Eugenia F Canziani, Ana Beatriz L Barra, Maria A Dalboni, Jorge P Strogoff-de-Matos, Rosilene M Elias, Rosa M A Moysés","doi":"10.1590/2175-8239-JBN-2024-0182en","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Data on parathyroid hormone (PTH) levels at hemodialysis (HD) initiation and during the first year of therapy are still scarce. We hypothesized that high baseline PTH levels contribute to more severe hyperparathyroidism during this period.</p><p><strong>Methods: </strong>Incident HD patients (n = 1,973) were divided into 3 groups according to PTH values (<150, 150-600, and > 600 pg/mL).</p><p><strong>Results: </strong>PTH levels at baseline and at 1 year were 273 (133-508) and 255 (128-471) pg/mL, respectively (p = 0.291). PTH < 150, 150-600 and >600 pg/mL were found in 28.1, 53.5 and 18.4%, respectively, at baseline and 30.7, 52.5 and 16.8% after 1 year (p = 0.015). Younger age, absence of diabetes, high baseline alkaline phosphatase and PTH were independent risk factors for PTH > 600 pg/mL after 1 year of HD.</p><p><strong>Conclusion: </strong>High PTH at the beginning and after 1 year of HD indicate poor conservative management before and during dialysis, and put patients at risk of requiring parathyroidectomy later.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240182"},"PeriodicalIF":1.3000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175965/pdf/","citationCount":"0","resultStr":"{\"title\":\"Serum parathyroid hormone trajectory during the first year of hemodialysis: a roadmap to severe hyperparathyroidism.\",\"authors\":\"Eduardo J Duque, Maria Eugenia F Canziani, Ana Beatriz L Barra, Maria A Dalboni, Jorge P Strogoff-de-Matos, Rosilene M Elias, Rosa M A Moysés\",\"doi\":\"10.1590/2175-8239-JBN-2024-0182en\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Data on parathyroid hormone (PTH) levels at hemodialysis (HD) initiation and during the first year of therapy are still scarce. We hypothesized that high baseline PTH levels contribute to more severe hyperparathyroidism during this period.</p><p><strong>Methods: </strong>Incident HD patients (n = 1,973) were divided into 3 groups according to PTH values (<150, 150-600, and > 600 pg/mL).</p><p><strong>Results: </strong>PTH levels at baseline and at 1 year were 273 (133-508) and 255 (128-471) pg/mL, respectively (p = 0.291). PTH < 150, 150-600 and >600 pg/mL were found in 28.1, 53.5 and 18.4%, respectively, at baseline and 30.7, 52.5 and 16.8% after 1 year (p = 0.015). Younger age, absence of diabetes, high baseline alkaline phosphatase and PTH were independent risk factors for PTH > 600 pg/mL after 1 year of HD.</p><p><strong>Conclusion: </strong>High PTH at the beginning and after 1 year of HD indicate poor conservative management before and during dialysis, and put patients at risk of requiring parathyroidectomy later.</p>\",\"PeriodicalId\":14724,\"journal\":{\"name\":\"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia\",\"volume\":\"47 2\",\"pages\":\"e20240182\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175965/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1590/2175-8239-JBN-2024-0182en\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/2175-8239-JBN-2024-0182en","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Serum parathyroid hormone trajectory during the first year of hemodialysis: a roadmap to severe hyperparathyroidism.
Background: Data on parathyroid hormone (PTH) levels at hemodialysis (HD) initiation and during the first year of therapy are still scarce. We hypothesized that high baseline PTH levels contribute to more severe hyperparathyroidism during this period.
Methods: Incident HD patients (n = 1,973) were divided into 3 groups according to PTH values (<150, 150-600, and > 600 pg/mL).
Results: PTH levels at baseline and at 1 year were 273 (133-508) and 255 (128-471) pg/mL, respectively (p = 0.291). PTH < 150, 150-600 and >600 pg/mL were found in 28.1, 53.5 and 18.4%, respectively, at baseline and 30.7, 52.5 and 16.8% after 1 year (p = 0.015). Younger age, absence of diabetes, high baseline alkaline phosphatase and PTH were independent risk factors for PTH > 600 pg/mL after 1 year of HD.
Conclusion: High PTH at the beginning and after 1 year of HD indicate poor conservative management before and during dialysis, and put patients at risk of requiring parathyroidectomy later.
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