Ho LT, Coward M, Negrea L
Effect of serum phosphorus on PTH secretion in
hemodialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1791 1996
It has been demonstrated that serum phosphorus is very important in the
development and treatment of hyperparathyroidism. Several investigators
have recently demonstrated that phosphorus can directly stimulate PTH
secretion. This abstract reports on a retrospective analysis of the effect
of serum phosphorus on serum PTH concentrations in a cohort of 248 chronic
hemodialysis patients. Serum phosphorus levels over a 3 month period were
averaged and correlated with serum PTH levels measured at the end of the 3
month period utilizing a linear model. The effect of various cofactors,
such as calcitriol use, diabetes, serum calcium, dialysis adequacy were
entered into the analysis.
Unfortunately, the poster offered very little data. The authors
noted a strong correlation between phosphorus and PTH which they claimed
was independent of all other variables, although many variables which
affect PTH and mineral metabolism, such as the presence of previous
parathyroidectomy were not included in their variables.
Comment: It is clear that control of serum phosphorus is extremely
improtant in the prevention and treatment of hyperparathyroidism. In
fact, one of the major reasons why patients fail therapy with vitamin D
analogues is the inability to control serum phosphorus. Because of the
nature of this study and the limited data provided, it is unclear what new
information this study provides.
(Stuart Sprague, M.D., Northwestern University, Chicago, IL)
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