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Abstract: TH-PO215

The Influence of Age on PTH/Vitamin D Relationship in Non-dialytic CKD

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Madureira, Ricardo, Hospital Sírio Libanês, São Paulo, Brazil
  • de Sa Carneiro Filho, Eduardo J. D., Universidade de Sao Paulo, Sao Paulo, Brazil
  • Elias, Rosilene M., Universidade de Sao Paulo, Sao Paulo, Brazil
  • Dalboni, Maria, UNINOVE, Sao Paulo, Brazil
  • Moyses, Rosa M.A., Universidade de Sao Paulo, Sao Paulo, Brazil
Background

Hypovitaminosis D is recognized as a worldwide epidemic. It is associated with elevation in parathormone (PTH), increasing the risk of fractures. Studies on general population have reported that the relationship between PTH and 25vitamin D (PTH/vitD) is influenced by aging. However, in chronic kidney disease (CKD) patients, the effect of on PTH/vitD remains unknown. This study aims to analyze the impact of age (≥ 65 years old) on PTH/vitD in non-dialytic CKD patients.

Methods

This is a cross-sectional study that analysed data from digital medical records of stage 3 CKD patients of outpatient Nephrology service of Hospital das Clínicas, Universidade de São Paulo. PTH/vitD was analyzed for the following categories: renal function, sex, furosemide and hydrochlorothiazide intake, serum calcium, oral cholecalciferol supplementation, phosphate binder and omeprazole.

Results

1178 patients (506 women and 672 men) with glomerular filtration rate (GFR) = 44.03 ± 8.74 mL/min/1.73m2 were analyzed. Elderly and women accounted for 57 and 48.7% of total patients, respectively. PTH/vitD was higher in women [2.81(1.79-4.18) vs. 2.5 (1.6-3.97), p<0.0001], elderly [2.83(1.91-4.38) vs. 2.33 (1.54-3.61); p<0.0001], CKD stage 3b [2.9 (1.95-4.55) vs. 2.34 (1.49-3.52), p<0.0001], furosemide [3.48 (2.22-5.58) vs. 2.5 (1.59-3.69), p<0.0001] and cholecalciferol users [2.9 (1.82-4.44) vs. 2.46 (1.57-3.55), p<0.0001]; and lower in hydrochlorothiazide users [2.54 (1.6-3.66) vs. 2.7 (1.7-4.3), p = 0.018]. We did not find any association with phosphate binders or omeprazole. There was a correlation between PTH/vitD and serum calcium (r= -0.140; p <0.0001). The multivariate analysis revealed that PTH/vitD was dependent on eGFR, sex, furosemide intake, serum calcium and age.

Conclusion

Our data shows that, elderly patients with CKD present higher PTH levels when compared with young adults with similar eGFR, calcium and vitamin D levels. Prospective studies are required to determine whether cholecalciferol reposition has an impact on vitamin D and PTH levels in this population.

Funding

  • Private Foundation Support