Avram MM, Sreedhara R, Ukiomogbe C, Thu T, Mittman N
Serum intact parathyroid hormone is a new independent
predictor of mortality in dialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1438 1996
The possible influence of iPTH level on the survival of HD patients was
studied. The authors gathered data on near 130 patients followed up to 9
years. Independent predictors of mortality were determined by Cox's
proportional hazards model. They were : age, nutritional markers, URR and
the iPTH level at the time of enrollment in the study.
Comment: The implications of these results would cast some doubt
about the
wisdom of letting the iPTH to be up to 2-3 times the normal range, in
dialysis patients. The authors reported increased mortality with levels of
200 or more, as well as with iPTH levels of 66 to 199. In addition,
neither the Ca nor the P levels were, by themselves, significant. The Ca x
P product was not disclosed and no studies were done to assess for
vasclar calcification, so it is hard to feel a great deal of enthusiasm
to support a change in current practices based on this study.
(Jose Ganel, M.D., University of California Davis at Sacramento,
CA)
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Am Soc Nephrol
CRF: Problem Areas :
Outcomes (Morbidity, Mortality)
CRF by problem area :
Bone disease/aluminum