The following is a summary of “Intradialytic serum phosphate variations are associated with low PTH levels,” published in the August 2024 issue of Nephrology by Lombardi et al.
Many studies have looked into how kidney replacement therapy (KRT) helps control phosphorus (P) levels in undergoing hemodialysis (HD).
Researchers conducted a retrospective study investigating whether reducing P during KRT impacts parathyroid hormone (PTH) levels.
They performed this study on the prevalent HD population at the University Hospital of Verona from January to December 2022, including stable adult patients undergoing HD with multiple follow-ups. The data on demographics, clinical details, and medications were collected. The linear mixed models were used to explore how changes in P during HD relate to PTH levels. The main exposure was the absolute change in P levels during HD (intra-HD ∆P). Multivariable linear mixed models examined the link between intra-HD ∆P and PTH levels.
The results showed that out of 211 patients with 904 visits, a positive link was found between intra-HD ∆P and pre-HD P (β = 0.76, 95% CI 0.75 to 0.78, P< 0.001) and urea reduction ratio (β = 0.38, 95% CI 0.35 to 0.41, P< 0.001). Higher intra-HD ∆P correlated to lower PTH levels (β = −0.16, 95% CI −0.30 to −0.03, P= 0.020).
Investigators concluded that reducing intra-HD P was linked to lower PTH levels. Improving dialysis efficiency can help manage P balance and secondary hyperparathyroidism, making intra-HD P reduction necessary for managing and tracking these conditions in patients undergoing HD.
Source: link.springer.com/article/10.1007/s40620-024-02062-y
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