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Misdiagnosis of chronic kidney disease and parathyroid hormone testing during the past 16 years

Haojie Liu1, Huan Zhao2, Danna Zheng2

  • 1The 2Nd Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.

Scientific Reports
|September 22, 2023
PubMed

Insights

Chronic kidney disease (CKD) has a high incidence and missed diagnosis rate. Low parathyroid hormone (PTH) testing and treatment for secondary hyperparathyroidism (SHPT) in CKD patients requires urgent clinical attention.

Area of Science:

  • Nephrology
  • Endocrinology
  • Public Health

Background:

  • Chronic kidney disease (CKD) is a global health concern.
  • Parathyroid hormone (PTH) is crucial for bone metabolism in CKD patients but often overlooked.
  • Secondary hyperparathyroidism (SHPT) is a common complication in advanced CKD.

Purpose of the Study:

  • To determine the incidence and diagnosis rates of CKD.
  • To evaluate PTH testing and SHPT treatment rates in stage 3-5 CKD patients.
  • To highlight diagnostic and treatment gaps in CKD management.

Main Methods:

  • Retrospective analysis of 5,301,391 patient records from Zhejiang Provincial People's Hospital (February 2006 - April 2022).
  • Data stratified by CKD incidence, diagnosis rates, PTH testing, and SHPT treatment.
  • Comparative analysis using PTH testing and SHPT treatment as key indicators.

Main Results:

  • CKD incidence was 13.14% with a 65.76% missed diagnosis rate.
  • Overall PTH testing rate was only 1.22%, with 15.37% in stage 3-5 CKD patients.
  • SHPT diagnosis rate in stage 3-5 CKD was 31.0%, with low prophylactic (7.4%) and post-diagnostic (22.2%) treatment rates.

Conclusions:

  • High CKD misdiagnosis and low PTH testing rates necessitate immediate clinical focus.
  • SHPT requires greater attention and timely intervention in patients with stage 3-5 CKD.
  • Improved diagnostic strategies and treatment protocols for CKD and SHPT are essential.

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