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The optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients
The serum intact parathyroid hormone (iPTH) is associated with the prognosis of hemodialysis (HD) patients, however, its optimal range for reducing mortality remains inconsistent. We designed a prospective cohort study of 346 incident HD patients to assess the association between different serum iPT...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018348/ https://www.ncbi.nlm.nih.gov/pubmed/33781171 http://dx.doi.org/10.1080/0886022X.2021.1903927 |
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author | Zhou, Xiaoling Guo, Yidan Luo, Yang |
author_facet | Zhou, Xiaoling Guo, Yidan Luo, Yang |
author_sort | Zhou, Xiaoling |
collection | PubMed |
description | The serum intact parathyroid hormone (iPTH) is associated with the prognosis of hemodialysis (HD) patients, however, its optimal range for reducing mortality remains inconsistent. We designed a prospective cohort study of 346 incident HD patients to assess the association between different serum iPTH level and mortality. According to the Kidney Disease Outcomes Quality Initiative (K/DOQI) international guidelines (2003), we divided patients into three groups (iPTH < 150 pg/mL, 150–300 pg/mL and >300 pg/mL). During the median follow-up of 58 months, 157 patients (45.38%) died. Multivariate Cox regression analysis showed that iPTH < 150 pg/mL and >300 pg/mL were associated with all-cause and cardiovascular mortality. Then, we performed a sensitivity analysis of patients divided into 6 serum PTH levels groups according to the folds of the K/DOQI target range. Multivariate Cox regression analysis showed that patients with serum iPTH ≥750 pg/mL, 600–749 pg/mL, 450–599 pg/mL had significantly higher risk of all-cause and cardiovascular mortality compared with those with serum iPTH in the range of 150–299 pg/mL. The association between serum iPTH and mortality shows a U-shaped curve. The optimal serum iPTH level which confers the lowest risk of all-cause and cardiovascular mortality could range from 150 pg/mL to 450 pg/mL in this group of incident HD patients. |
format | Online Article Text |
id | pubmed-8018348 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-80183482021-04-13 The optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients Zhou, Xiaoling Guo, Yidan Luo, Yang Ren Fail Clinical Study The serum intact parathyroid hormone (iPTH) is associated with the prognosis of hemodialysis (HD) patients, however, its optimal range for reducing mortality remains inconsistent. We designed a prospective cohort study of 346 incident HD patients to assess the association between different serum iPTH level and mortality. According to the Kidney Disease Outcomes Quality Initiative (K/DOQI) international guidelines (2003), we divided patients into three groups (iPTH < 150 pg/mL, 150–300 pg/mL and >300 pg/mL). During the median follow-up of 58 months, 157 patients (45.38%) died. Multivariate Cox regression analysis showed that iPTH < 150 pg/mL and >300 pg/mL were associated with all-cause and cardiovascular mortality. Then, we performed a sensitivity analysis of patients divided into 6 serum PTH levels groups according to the folds of the K/DOQI target range. Multivariate Cox regression analysis showed that patients with serum iPTH ≥750 pg/mL, 600–749 pg/mL, 450–599 pg/mL had significantly higher risk of all-cause and cardiovascular mortality compared with those with serum iPTH in the range of 150–299 pg/mL. The association between serum iPTH and mortality shows a U-shaped curve. The optimal serum iPTH level which confers the lowest risk of all-cause and cardiovascular mortality could range from 150 pg/mL to 450 pg/mL in this group of incident HD patients. Taylor & Francis 2021-03-29 /pmc/articles/PMC8018348/ /pubmed/33781171 http://dx.doi.org/10.1080/0886022X.2021.1903927 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Zhou, Xiaoling Guo, Yidan Luo, Yang The optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients |
title | The optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients |
title_full | The optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients |
title_fullStr | The optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients |
title_full_unstemmed | The optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients |
title_short | The optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients |
title_sort | optimal range of serum intact parathyroid hormone for a lower risk of mortality in the incident hemodialysis patients |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018348/ https://www.ncbi.nlm.nih.gov/pubmed/33781171 http://dx.doi.org/10.1080/0886022X.2021.1903927 |
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