Abstract: FR-PO481

Prevalence of Secondary Hyperparathyroidism among Patients with Diabetic Nephropathy

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Imam, Mahmoud Hamada, Benha University, Benha, Egypt
  • Elshourbagy, Ahmed Wagih, banha faculty of medicine, Benha, Egypt
  • Mohamady, Amira, Benha University, Benha, Egypt
  • Sarhan, Rizk sayad rizk, Benha University, Benha, Egypt
Background

Both SHPT and diabetes mellitus have increased the risk for cardiovascular complication mainly through vascular calcification and endothelial dysfunction. The prevalence of SHPT among diabetic nephropathy patients is not previously studied. The aim of this study to evaluate the prevalence of SHPT among diabetic nephropathy patients attended to diabetes and nephrology outpatient clinic.

Methods

In this retrospective study, 437 diabetic patients were enrolled in this study from 864 diabetic patients who attended diabetes and nephrology outpatient clinics in our tertiary care hospital in Jeddah from Jan 2014 to Feb 2017. Inclusion criteria were: [1] Age ≥18 years, [2] Patient had diabetic nephropathy which was diagnosed based on the presence of urinary albumin/creatinine ratio (uACR) ≥ 30 mg/gm ± 24 hours’ urinary protein measurement ≥ 300 mg/day. Exclusion criteria were|: [1] patients were already receiving cinacalcet and/or[2] patients had undergone neck surgery for parathyroidectomy. The intact parathyroid hormone, 25 vitamin D level, uACR and other kidney and biochemical investigation results were obtained from patients’ medical records. Patients were divided into two groups: those with euparathyroidism (an iPTH level less than 65 pg/mL) and those with hyperparathyroidism with iPTH level above or equal to 66 pg/mL.

Results

Three hundred and seventy-four patients (85.5%) had an iPTH level above normal. When patients were divided according to their iPTH level into SHPT and euparathyroid groups, we found a significant mean difference between the two groups regarding uACR (2.38 ± 1.0 mg/g vs. 311 ± 180 mg/g; p <0.001), eGFR (49.15 ± 20.3 ml/min/1.73m2 vs. 90.97 ± 3.93 ml/min/1.73m2; p < 0.001), and serum urea (77.54 ± 26.19 mg/dL vs. 23.70 ± 5.66 mg/dL; p < 0.001). Our results showed that SHPT group had a statistically significant lower level of vitamin D and serum calcium. Furthermore, we found that there was a strong correlation between iPTH level and serum creatinine, eGFR, UACR, vitamin D.

Conclusion

Despite the absence of clinical manifestations, SHPT is common among diabetic nephropathy patients.