Abstract: SA-PO707
Determinants of Secondary Hyperparathyroidism Progression in CKD Patients
Session Information
- Bone and Mineral Metabolism: Clinical - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Vasco, Raquel F. V., Universidade de Sao Paulo, Sao Paulo, Brazil
- Carvalho Goncalves, Flávia Leticia, Universidade de Sao Paulo, Sao Paulo, Brazil
- Elias, Rosilene M., Universidade de Sao Paulo, Sao Paulo, Brazil
- Moyses, Rosa M.A., Universidade de Sao Paulo, Sao Paulo, Brazil
Background
Secondary hyperparathyroidism (SHPT) is a common complication in patients with CKD and should be early identified and managed. However, it is still unknown which factors are associated with SHPT progression.
Methods
Electronic charts of all nephrology outpatients clinic (n=1,170) in the period between Jan-2017 and Dec-2017 with CKD stages 3 and 4 were included. Estimated glomerular filtration rate (eGFR) based on CKD-EPI equation and biochemical parameters were assessed. Patients were divided in two groups: those who exhibited SHPT (final PTH > 150 pg/ml; n= 279) and those who did not (n = 891).
Results
Patients who developed SHPT had lower basal calcium (9.45 ± 0.6 vs. 9.57 ± 0.5 mg/dl), eGFR (24±7 vs. 34±11 ml/min, p=0.002) and 25 vitD (25±10 vs. 27±10 ng/dl, p=0.002), despite a trend for a higher prevalence of cholecalciferol supplementation (77 vs. 72%, p=0.07). They also had higher phosphate (3.68 ± 0.7 vs. 3.52 ± 0.7 mg/dl, p=0.001) and eGFR loss (3.3±6 vs. 1.0±7.6 ml/mi, p=0.0001). No association was found for age or gender. Multivariate analysis disclosed that SHPT progression was associated with more rapid progression of CKD, as well as lower vit D and higher phosphate at baseline.
Conclusion
Our data suggest that patients with faster progression of SHPT present lower eGFR and 25 vitD and higher phosphate, even within the reference range. These patients should be closely monitored and future prospective studies might show whether interventions such as phosphate restriction and more vigorous cholecalciferol supplementation could change the SHPT natural history.