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Abstract: PO0351

Parathyroid Hormone Serum Levels and Mortality Among Hemodialysis Patients in the Gulf Cooperation Council Countries: Results from the DOPPS (2012-2018)

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Al Salmi, Issa, The Royal Hospital, Ministry of Health, Muscat, Oman
  • Al Rukhaimi, Mona, Dubai Medical College, Dubai, United Arab Emirates
  • AlSahow, Ali, Jahra Hospital, Jahra, Kuwait
  • Shaheen, Faissal A., DSFH, Jeddah, Saudi Arabia
  • Al-Ghamdi, Saeed, King Abdulaziz University, Jeddah, Saudi Arabia
  • Al Wakeel, Jamal S., King Abdulaziz University, Jeddah, Saudi Arabia
  • Al-Ali, Fadwa M., Hamad General Hospital, Doha, Qatar
  • Alaradi, Ali, Salmaniya Medical Complex, Manama, Bahrain
  • Alhejaili, Fayez F., King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  • Almaimani, Yaqoob Ahmed, The Royal Hospital, Ministry of Health, Muscat, Oman
  • Abdelhamid, Essam Fouly, Amgen UAE, Dubai, United Arab Emirates
  • Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Group or Team Name

  • On behalf of the GCC-DOPPS Study Group
Background

The prospective Dialysis Outcomes and Practice Patterns Study (DOPPS) has collected data since 2012 in all six Gulf cooperation council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates). Here, we report the relationship of PTH with mortality in the largest GCC hemodialysis (HD) patient cohort studied to date.

Methods

Data were from randomly-selected national samples of HD facilities in GCC DOPPS phases 5 and 6 (2012-2018). PTH descriptive findings and case-mix adjusted PTH/mortality Cox regression analyses were based on 1825 and 1422 randomly-selected HD patients, respectively.

Results

Mean patient age was 55 years (median dialysis vintage = 2.1 years). Median PTH ranged from 259 pg/mL (UAE) to 437 pg/mL (Kuwait), with 22% having PTH <150 pg/mL, 24% (PTH 150-300), 34% (PTH 301-700), and 20% (PTH >700) pg/mL. Patients with PTH >700 pg/mL were younger, on dialysis longer, less likely to be diabetic, have urine>200 mL/day, prescribed 3.5 mEq/L dialysate calcium, had higher mean serum creatinine and phosphorus levels, lower white blood cell counts, and more likely to be prescribed cinacalcet, phosphate binders, or IV vitamin D. A “U-shaped” PTH/mortality relationship was observed with >2-fold and 1.5 fold higher adjusted HR of death at PTH>700 pg/mL and <300 pg/mL, respectively, compared to PTH 301-450 pg/mL.

Conclusion

Secondary hyperparathyroidism is highly prevalent among GCC HD patients, with a strong U-shaped PTH/mortality relationship seen at PTH <300 and >450 pg/mL. Future studies are encouraged for further understanding this PTH/mortality pattern in relationship to unique aspects of the GCC HD population.

Funding

  • Commercial Support