Analysis of correlated factors on maintenance hemodialysis patients with parathyroid dysfunction

Objective To analyze the related factors on the maintenance hemodialysis patients with parathyroid dysfunction, and further analyzed the independent risk factors of abnormal parathyroid hormone in MHD patients.Methods 85 patients were divided into PTH reduced group(iPTH<150 ng/L), PTH normal group(150 ng/L≤iPTH≤300 ng/L) and PTH increased group(iPTH>300 ng/L) according to the levels of intact parathyroid hormone. Hamilton depression scale(HAMD 24 items) was adopted to evaluate depression status of patients. The indicators of age, dialysis age, morbidity of diabetes, prevalence of depression, body mass index(BMI) and serum biochemical variables were compared in this study. Multiple linear regression was used to analyze the correlation of iPTH and the above indicators. Moreover, multifactor logistic regression was also employed to analyze the risk factors on iPTH levels abnormity.Results Compared with PTH normal group, serum calcium levels were lower(P<0.05) and the diabetes morbidity rate and depression morbidity rate were higher in the PTH reduced group(P<0.05), the hemoglobin was lower, age and serum creatinine level were higher in the PTH increased group. The serum iron and transferrin saturation of PTH reduced group and PTH increased group were lower in comparison with PTH normal group. Dialysis age, C-reactive protein, hematocrit, ferritin total iron binding force and serum phosphorus of the three groups showed no statistical significance(P>0.05). The result of multiple logistic linear regression showed that the iPTH was positively correlated with BMI and age(r=0.040, 0.051), and negatively correlated with hemoglobin and diabetes(r=-0.039, -0.357). The logistic linear regression showed that diabetes was the independent risk factors for reduced iPTH, and BMI, serum creatinine were the independent risk factors for increased iPTH.Conclusions The iPTH level in MHD patients was positively correlated with BMI and age, and negatively correlated with hemoglobin and diabetes. Diabetes, BMI and serum creatinine were independent risk factors of the abnormal level of PTH.