Effect of type II diabetes mellitus on intact parathyroid hormone level in end stage renal disease patients on maintenance hemodialysis

摘要

Introduction: Osteodystrophy is more co mmon among hemodialysis patients than normal population. Earlier the higher incidence of osteod ystrophy among maintenance hemodialysis (MHD) patients was attributed to high Intact Parathyroid Hormone (iPTH) level (150-300 pg/ml). Osteodystrophy due to high iPTH level is called High Turnover Bone Disease (HTBD). It was later found that another type of osteodystrophy, which can be attributed to low iPTH level and called Low Turnover Bone Disease (LTBD), also afflicts a subset of hemo dialysis population, the diabetic End Stage Renal Disease (ESRD) patients. In our study, we propose to ascertain if diabetic ESRD patients on MHD have lower iPTH level than their non- diabetic counterparts. Methods: Total 193 patients were enrolled into the study. Of them, 98 had diabetic nephropathy as primary cause of ESRD, 69 had Chronic Glomerulonephritis, 13 had Hypertensive Nephropathy, 8 had Polycystic Kidney Disease, 3 had Urolithiasis and 2 had Drug Induced Nephrotoxicity as primary cause of ESRD. All of them had been on MHD for more than 6 months. We measured the iPTH level of all the patients enrolled in the study. Result. Serum iPTH level was significantly lo wer in diabetic group than in non-diabetic group (P < 0.001). Conclusion: Type 2 Diabetes Mellitus contributes towards relatively low iPTH level in diabetic ESRD patients on MHD.