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Changes in parathyroid hormone in diabetic patients on long-term hemodialysis
K Kikunami1, Y Nishizawa, T Tabata
1Inoue Hospital, Suita, Japan.
Insights
Diabetic kidney disease patients on hemodialysis show slower secondary hyperparathyroidism progression. Parathyroid hormone and osteocalcin levels changed differently in diabetic versus non-diabetic hemodialysis patients over three years.
Area of Science:
- Nephrology
- Endocrinology
- Metabolic Bone Disease
Background:
- Diabetic nephropathy is a common complication of diabetes, often leading to chronic kidney disease.
- Secondary hyperparathyroidism is prevalent in patients with chronic kidney disease, affecting bone metabolism.
- Understanding the progression of secondary hyperparathyroidism in diabetic versus non-diabetic hemodialysis patients is crucial for management.
Purpose of the Study:
- To compare the changes in parathyroid hormone (PTH) and osteocalcin levels over three years in hemodialyzed patients with diabetic nephropathy (HD/DM) and those without diabetes (HD/non-DM).
- To investigate the differential progression rates of secondary hyperparathyroidism in these two patient groups.
Main Methods:
- Longitudinal study over 3 years.
- Measurement of serum carboxyl-terminal PTH, mid-region PTH, and osteocalcin concentrations.
- Comparison of biomarker changes between HD/DM and HD/non-DM patient groups.
Main Results:
- In HD/DM patients, serum carboxyl-terminal PTH and osteocalcin concentrations did not change significantly.
- In HD/non-DM patients, serum carboxyl-terminal PTH and osteocalcin concentrations increased significantly.
- Mean mid-region PTH concentration increased significantly in both HD/DM and HD/non-DM patients.
Conclusions:
- Secondary hyperparathyroidism develops more slowly in hemodialyzed patients with diabetic nephropathy compared to those without diabetes.
- Differential changes in PTH and osteocalcin suggest distinct pathophysiological pathways or slower disease progression in diabetic kidney disease patients undergoing hemodialysis.
Abstract:
Changes in parathyroid hormone (PTH) and osteocalcin over 3 years were studied in hemodialyzed patients with diabetic nephropathy (HD/DM) and hemodialyzed patients without diabetes (HD/non-DM). In HD/DM patients, concentrations of the carboxyl terminal regions of PTH and osteocalcin in the serum did not change significantly, but in HD/non-DM patients, both concentrations increased significantly. In patients in both groups, the mean concentration of the mid-region of PTH increased significantly. Secondary hyperparathyroidism in HD/DM develops slower than in HD/non-DM.