Secondary hyperparathyroidism in patients with chronic kidney disease in Tyumen region: five-year follow-up data
- Authors: Avdeeva V.A.1, Syachina S.N.1, Eirich V.V.1,2, Zhmurov D.V.1, Zhmurov V.A.1
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Affiliations:
- Tyumen State Medical University
- Regional clinical hospital No. 1
- Issue: Vol 16, No 1 (2024)
- Pages: 49-53
- Section: Original Articles
- URL: https://journals.eco-vector.com/2075-3594/article/view/631120
- DOI: https://doi.org/10.18565/nephrology.2024.1.49-53
- ID: 631120
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Abstract
Background. Secondary hyperparathyroidism (SHPT) is the most common type of mineral-bone disorder (MBD), closely associated not only with an increased risk of progression of chronic kidney disease (CKD), but also with damage to the cardiovascular system (CVS).
Objective. Evaluation of the clinical and laboratory features of SHPT against the background of CKD in Tyumen region.
Material and methods. A retrospective analysis of 416 medical records of patients with diagnoses of CKD stage 3–5 and SHPT who were examined and treated in the Nephrology Department of Tyumen Regional Clinical Hospital No. 1 during the period from 01/01/2018 to 12/31/2022 was carried out. Demographic and anthropometric data were studied, laboratory (total and ionized calcium, total protein, albumin, phosphorus, creatinine, parathyroid hormone, 25(OH)D, alkaline phosphatase) tests and and instrumental methods of diagnosis (Echo-CG, ultrasound of the abdominal cavity and retroperitoneal space) were assessed.
Results. There were 184 (44.2%) men and 232 (55.8%) women. The mean age of the study subjects was 56.7±14.02 years. The mean duration of CKD was 3.5±4.3 years. According to the etiological structure of CKD among all patients, the leading position was occupied by primary kidney diseases (60%), including: polycystic kidney disease – 21%, chronic glomerulonephritis – 14%, chronic pyelonephritis – 19%, chronic tubulointerstitial nephritis – 6%. The second place in the etiological structure of CKD was occupied by diabetes mellitus (27%) and 13% by other diseases. Analysis of laboratory parameters of the examined patients confirmed the presence of the classic course of SHTP in patients with CKD: an increase in the mean parathyroid hormone level by 5.3 times, serum creatinine – by 6.5 times, as well as a slight increase in phosphorus and alkaline phosphatase levels compared with reference values were detected.
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About the authors
Valeria A. Avdeeva
Tyumen State Medical University
Email: dr.avdeeva@yahoo.com
ORCID iD: 0000-0002-8642-9435
Cand.Sci. (Med.), Associate Professor of the Department of Propaedeutics of Internal Diseases, Institute of Clinical Medicine
Russian Federation, TyumenSofya N. Syachina
Tyumen State Medical University
Email: sonya.ya_3005@mail.ru
Resident at the Department of Propaedeutics of Internal Diseases, Institute of Clinical Medicine
Russian Federation, TyumenVictoria V. Eirich
Tyumen State Medical University; Regional clinical hospital No. 1
Email: dr.avdeeva@yahoo.com
Nephrologist at the Regional Clinical Hospital No. 1
Russian Federation, Tyumen; TyumenDenis V. Zhmurov
Tyumen State Medical University
Author for correspondence.
Email: zhmurovdv@tyumsmu.ru
ORCID iD: 0000-0003-3167-5310
Cand.Sci. (Med.), Associate Professor at the Department of Propaedeutics of Internal Diseases, Institute of Clinical Medicine
Russian Federation, TyumenVladimir A. Zhmurov
Tyumen State Medical University
Email: zhmurovva@tyumsmu.ru
ORCID iD: 0000-0002-7228-6197
Dr.Sci.(Med.), Professor, Head of the Department of Propaedeutics of Internal Diseases, Institute of Clinical Medicine
Russian Federation, TyumenReferences
- Бобкова И.Н., Ватазин А.В., Ветчинникова О.Н. и др. Клинические рекомендации ассоциации нефрологов. Хроническая болезнь почек (ХБП). 2023. 233 с. [Bobkova I.N., Vatazin A.V., Vetchinnikova O.N., etc. Clinical recommendations of the Association of Nephrologists. Chronic kidney disease (CKD). 2023. 233 p. (In Russ.)].
- Kovesdy C.P. Epidemiology of chronic kidney disease: An update 2022. Kidney Int. Suppl. 2021;12:7–11.
- Томилина Н.А., Андрусев А.М., Перегудова Н.Г. и др. Заместительная терапия терминальной хронической почечной недостаточности. Отчет по данным Общероссийского Регистра заместительной почечной терапии Российского диализного общества. Часть первая. Нефрология и диализ. 2017;19(4):1–95. [Tomilina N.A., Andrusev A.M., Peregudova N.G., etc. Substitution therapy for terminal chronic renal failure. A report on the data of the All-Russian Register of Renal Replacement Therapy of the Russian Dialysis Society. Part one. Nephrology and dialysis. 2017;19(4):1–95 (In Russ.)].
- Ветчинникова О.Н. Гиперпаратиреоз при хронической болезни почек. Эффективная фармакотерапия. 2013;44:26–33. [Vetchinnikova O.N. Hyperparathyroidism in chronic kidney disease. Effective pharmacotherapy. 2013;44:26–33 (In Russ.)].
- Мокрышева Н.Г., Еремкина А.К., Мирная С.С. и др. Клинические рекомендации по первичному гиперпаратиреозу, краткая версия. Проблемы эндокринологии. 2021;67(4):94–124. [Mokrysheva N.G., Eremkina A.K., Mirnaya S.S., etc. Clinical recommendations for primary hyperparathyroidism, short version. Problems of endocrinology. 2021;67(4):94–124 (In Russ.)].
- Саприна Т.В., Жулина Е.М., Жулин Д.С. и др. Распространенность и современные подходы к лечению вторичного гиперпаратиреоза и его осложнений при хронической болезни почек: обзор литературы. Сибирский журнал клинической и экспериментальной медицины. 2023;38(2):72–81. [Saprina T.V., Zhulina E.M., Zhulin D.S. and others. Prevalence and modern approaches to the treatment of secondary hyperparathyroidism and its complications in chronic kidney disease: a literature review. Siberian Journal of Clinical and Experimental Medicine. 2023;38(2):72–81 (In Russ.)].
- Kidney Disease: Improving Global Outcomes (KDIGO) CD-MBD Work Group. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease – mineral and bone disorder (CKD-MBD). Kidney Int. Suppl. 2011. 2017;7(1):1–59.
- Wei Y., Lin J., Yang F., et al. Risk factors associated with secondary hyperparathyroidism in patients with chronic kidney disease. Exp. Ther. Med. 2016;12:1206–12.
- Streja E., Wang H.Y., Lau W.L., et al. Mortality of combined serum phosphorus and parathyroid hormone concentrations and their changes over time in hemodialysis patients. Bone. 2014;61:201–07.
- Geng S., Kuang Z., Peissig P.L., et al. Parathyroid hormone independently predicts fracture, vascular events, and death in patients with stage 3 and 4 chronic kidney disease. Osteoporos Int. 2019;30:2019–2025.
- Drüeke TB. Hyperparathyroidism in Chronic Kidney Disease. 2021 Oct 18. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. [PMID: 25905209].
- Tentori F., Wang M., Bieber B.A., et al. Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: the DOPPS study. Clin. J. Am. Soc. Nephrol. 2015;10(1):98–109.
- Isakova T., Cai X., Lee J., et al. Longitudinal evolution of markers of mineral metabolism in patients with CKD: the Chronic Renal Insufficiency Cohort (CRIC) Study. Am. J. Kidney Dis. 2020;75:235–44.
- Tomaschitz A., Ritz E., Pieske B., et al. Aldosterone and parathyroid hormone interactions as mediators of metabolic and cardiovascular disease. Metab. 2014;63:20–31.
- D'Marco L., Bellasi A., Raggi P. Cardiovascular biomarkers in chronic kidney disease: state of current research and clinical applicability. Dis. Markers. 2015;2015:586569.
- Chinnappa S., Hothi S.S., Tan L.B. Is uremic cardiomyopathy a direct consequence of chronic kidney disease? Expert Rev. Cardiovasc. Ther. 2014;12:127–130.
- Chirakarnjanakorn S., Navaneethan S.D., Francis G.S., et al. Cardiovascular impact in patients undergoing maintenance hemodialysis: Clinical management considerations. Int. J. Cardiol. 2017;232:12–23.
- Chen H., Han X., Cui Y., et al. Parathyroid Hormone Fragments: New Targets for the Diagnosis and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder. Biomed. Res. Int. 2018;2018:9619253.
- Moe S.M., Chertow G.M., Parfrey P.S., et al. Cinacalcet, fibroblast growth factor-23, and cardiovascular disease in hemodialysis: the Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) trial. Circulation 2015;132:27–39.
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