Impact of elevated intact parathyroid hormone on mortality and renal disease progression in patients with chronic kidney disease stages 3 and 4
Impact of elevated intact parathyroid hormone on mortality and renal disease progression in patients with chronic kidney disease stages 3 and 4
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DOI：
10.1185/03007995.2012.716029
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发表时间：
2012-09-01
影响因子：
2.3
通讯作者：
Andress, D.
中科院分区：
文献类型：
--
作者：
Asche, C. V.;Marx, S. E.;Andress, D.
目的：评价甲状旁腺素水平升高对3期和4期慢性肾脏病患者至死亡时间和肾脏替代治疗的影响。方法：回顾性队列分析1996年1月至2007年9月11,092例3期和4期慢性肾脏病患者，采用Cockroft-Gault和肾脏病饮食改良公式估计肾小球滤过率。患者的最高甲状旁腺激素水平用于定义索引日期和队列（随访1年）。死亡率和肾脏替代治疗事件之间的队列在预先定义的甲状旁腺激素levels.Results：作为全段甲状旁腺激素水平的增加，平均年龄，女性人数和估计肾小球滤过率下降。完整甲状旁腺激素水平500 pg/mL的患者为2.67（1.84-3.84）。结论：慢性肾脏病3期和4期患者的完整甲状旁腺激素水平>50 pg/mL与死亡或RRT的联合风险升高相关。
Objective:To estimate the impact of elevated intact parathyroid hormone levels on time to death and renal replacement therapy in patients with chronic kidney disease stages 3 and 4.Methods:A retrospective cohort analysis from 01/1996 to 09/2007 was conducted in 11,092 patients with chronic kidney disease stages 3 and 4 patients using Cockroft-Gault and Modification of Diet in Renal Disease equations to estimate their glomerular filtration rates. Patients' highest parathyroid hormone levels were used to define the index date and cohort (followed for 1 year). Mortality and renal replacement therapy events were evaluated among cohorts at pre-defined parathyroid hormone levels.Results:As the intact parathyroid hormone levels increased, the mean age, number of females and estimated glomerular filtration rates decreased. Patients with an intact parathyroid hormone level 500 pg/mL was 2.67 (1.84-3.84).Conclusion:Intact parathyroid hormone levels >50 pg/mL in patients with chronic kidney disease stages 3 and 4 are associated with an escalating combined risk of death or RRT.