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Abstract: TH-PO580

Female Sex Enhances the Association of Secondary Hyperparathyroidism with Increased Bone Turnover Marker in Aged Patients Receiving Hemodialysis

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical


  • Hamano, Naoto, Tokai University School of Medicine, Isehara, Japan
  • Komaba, Hirotaka, Tokai University School of Medicine, Isehara, Japan
  • Kakuta, Takatoshi, Tokai University Hachioji Hospital, Hachioji, ToKyo, Japan
  • Wada, Takehiko, Tokai University School of Medicine, Isehara, Japan
  • Takahashi, Yuichiro, Jinken Clinic, Ebina, Japan
  • Hyodo, Toru, Eijin Clinic and Cambodian Association of Nephrology, Hiratsuka, Kanagawa, Japan
  • Hida, Miho, Kurata Hospital, Hiratsuka, Japan
  • Fukagawa, Masafumi, Tokai University School of Medicine, Isehara, Japan

Female patients undergoing dialysis are at higher risk of fracture than male patients, suggesting the involvement of postmenopausal osteoporosis. However, little is known about the impact of menopause on altered bone metabolism associated with secondary hyperparathyroidism in this population.


We analyzed data from a cohort of 654 patients receiving maintenance hemodialysis. We examined the hypothesis that female sex is associated with elevated levels of bone-specific alkaline phosphatase (BAP) and enhances the association between intact parathyroid hormone (PTH) and BAP in aged hemodialysis patients.


Females had significantly higher levels of BAP compared to males in patients aged ≥50 years, but not in patients aged <50 years (P for interaction by age <0.001). This difference observed in the aged population remained significant after adjustment of age, diabetes, dialysis vintage, body-mass index, and PTH. In the overall cohort or in either of the age subgroups, increased PTH was significantly associated with increased BAP independently of age, diabetes, dialysis vintage, and body-mass index. Among patients aged ≥50 years, the association between PTH and BAP was pronounced in females compared with males (P for interaction by sex <0.001), but such effect modification by sex was not observed among patients aged <50 years.


Our results show that female sex enhances the increased bone turnover associated with secondary hyperparathyroidism in aged hemodialysis patients, highlighting the involvement of postmenopausal osteoporosis in high-turnover renal osteodystrophy.


  • Government Support - Non-U.S.