Research Article

Hyperparathyroidism and Associated Factors in Chronic Kidney Disease

Shoukat Memon
The Indus Health Network, Pakistan
* Corresponding author
Ashar Alam
The Indus Health Network, Pakistan
Faiza Saeed
The Indus Health Network, Pakistan
Javeria Chughtai
The Indus Hospital, Pakistan
Salman Imtiaz
The Indus Health Network, Pakistan
Shahzad Ahmed
The Indus Health Network, Pakistan
Sobia Tariq
The Indus Health Network, Pakistan
DOI icon 10.24018/clinicmed.2022.3.2.173

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Submitted 2022-02-02
Published 2022-03-02

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Article Main Content

Background: The normal axis of calcium, phosphorus, vitamin D, and intact parathyroid hormone (iPTH) come under stress when chronic kidney disease (CKD) progresses beyond stage 3(GFR<30 ml/kg/1.732). This results in increased secretion of iPTH which is known as secondary hyperparathyroidism. This exacerbates further if simultaneous deficiency of nutritional vitamin D (Cholecalciferol) is also found. Secondary hyperparathyroidism results in vascular calcification and increases cardiac mortality. Early intervention in form of dietary modification (low phosphorus, low potassium), correcting vitamin D deficiency along with the addition of active vitamin D (calcitriol) would help in alleviating patients’ suffering and saving costs as well.

Material and method: This study was conducted from Jan 2017 to Jan 2018 at The Indus Hospital, Karachi with the age group ≥14 years of either gender who were suffering from chronic kidney disease (CKD). Patients on dialysis, chronic liver disease, and vitamin D supplementation were excluded. Their history, demographic, BMI, Calcium, Phosphorus, Alkaline Phosphatase, 25-Hyydorxyvitamin D, albumin, and intact parathyroid hormone (iPTH) were all noted.

Results: 265 patients were enrolled for final analysis in this data with a male to female ratio of 1:1.03 (146/121). Hyperparathyroidism (iPTH> 68 pg/ml) was seen in 190 (71.2%) patients. Mean values of all quantitative variables were not statistically significant when compared hyper parathyroid with normal parathyroid. Hyperparathyroidism was found significant in late CKD in comparison to early CKD (P-value <.001), While vitamin D deficiency was significantly associated with hyperparathyroidism in early CKD but not in late CKD.

Conclusion: Hyperparathyroidism is significantly present in CKD which is contributed by CKD progression and vitamin D deficiency.

Keywords: Chronic Kidney Disease, hyperparathyroidism, intact Parathyroid hormone, vitamin D

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