ArticleInternational urology and nephrology2017
Elderly patients with chronic kidney disease have higher risk of hyperparathyroidism.
Article in International urology and nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 10 citations in OpenAlex.
- Potential Role of Bone Metabolism Markers in Kidney Transplant Recipients.Current medicinal chemistry · 2024Article
- Depression and quality of life in older adults on hemodialysis.Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2020Article
- CKD-MBD: from the Pathogenesis to the Identification and Development of Potential Novel Therapeutic Targets.Current osteoporosis reports · 2018Review
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2 authors at 1 institution in 1 country.
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Abstract
purposeAs the world's population ages, the incidence of chronic kidney disease (CKD) is growing. There is ongoing debate regarding whether high levels of parathyroid hormone (PTH) would be more common in elderly than young patients, and which factors are driven the risk of secondary hyperparathyroidism (SHPT), independent of renal function.
methodsElderly patients (age ≥ 65 years, N = 518) were compared to a 1:1 sex- and estimated glomerular filtration rate (eGFR)-matched sample of young patients (age < 65 years), in a cross-sectional analysis. Demographic, biochemical and drug prescription data were collected from electronic charts. The main outcome measure was the prevalence of SHPT, defined as PTH > 65 pg/mL.
resultsElderly patients presented higher serum calcium and PTH levels and lower serum phosphate, and were taking more diuretics than young patients. SHPT was more frequent among elderly patients (49.4 vs. 38.6%, p = 0.005), and it was associated with lower eGFR, low levels of 25(OH) vitamin D and with furosemide therapy, while thiazide use was a protector factor. Elderly patients with 25(OH) vitamin D > 40 ng/mL were protected against SHPT. The Ca/PTH ratio was lower in elderly than in young patients [0.15 (0.10, 0.20) vs. 0.16 (0.11, 0.23), respectively, p = 0.003].
conclusionCKD elderly patients have higher risk of SHPT than young, which cannot be explained solely by renal function. Besides low levels of vitamin D, furosemide therapy and a distinct relationship between calcium and PTH are possible factors contributing to SHPT. Whether this is a result of renal resistance to PTH or an altered set point to calcium deserves further investigation.
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