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The PTH (1-84)/non-PTH (1-84) ratio is a risk factor for cardiovascular events in hemodialysis patients

E Zitt1, A H Kirsch, M Haueis

  • 1Department of Internal Medicine IV, Nephrology and Hypertension, Innsbruck Medical University, Innsbruck, Austria.

Clinical Nephrology
|March 24, 2011
PubMed

Insights

The parathyroid hormone (PTH) ratio may help predict cardiovascular events in hemodialysis patients. A higher PTH ratio is linked to increased cardiovascular risk, suggesting its utility in risk assessment.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Cardiovascular disease (CVD) is a leading cause of mortality in hemodialysis patients.
  • The parathyroid hormone (PTH) (1-84)/non-PTH (1-84) ratio (PTH ratio) is a novel biomarker.
  • The potential of the PTH ratio to assess cardiovascular risk in this population remains unclear.

Purpose of the Study:

  • To investigate the association between the PTH ratio and cardiovascular events (CVE) in hemodialysis patients.
  • To determine if the PTH ratio can serve as a predictor of cardiovascular risk.

Main Methods:

  • Prospective cohort study of 70 prevalent hemodialysis patients followed for up to 4 years.
  • Baseline PTH ratio measurement.
  • Primary outcomes: cardiovascular events (CVE) and all-cause mortality.
  • Cox proportional hazards modeling to assess risk association.

Main Results:

  • A PTH ratio > 1 was observed in 49% of patients.
  • Patients with CVE exhibited a significantly higher PTH ratio compared to event-free patients (p=0.033).
  • A PTH ratio > 1 was associated with a higher incidence of CVE (53% vs. 22%, p=0.013) and shorter event-free survival (p=0.032).
  • Higher PTH ratio independently predicted elevated CVE risk (HR=3.2, p=0.04).

Conclusions:

  • An elevated PTH (1-84)/non-PTH (1-84) ratio is significantly associated with increased cardiovascular risk in hemodialysis patients.
  • The PTH ratio shows promise as a valuable tool for cardiovascular risk stratification in this high-risk group.
Abstract

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