Abstract
Background and objectives: The prevalence of mineral metabolism abnormalities is almost universal in stage 5 chronic kidney disease (CKD), but the presence of abnormalities in milder CKD is not well characterized. Design, setting, participants, & measurements: Data on adults ≥20 yr of age from the National Health and Nutrition Examination Survey 2003-2004 (N = 3949) were analyzed to determine the association between moderate declines in estimated GFR (eGFR), calculated using the Modfication of Diet in Renal Disease formula, and serum intact parathyroid hormone (iPTH) ≥ 70 pg/ml. Results: The geometric mean iPTH level was 39.3 pg/ml. The age-standardized prevalence of elevated iPTH was 8.2%, 19.3%, and 38.3% for participants with eGFR ≥ 60, 45 to 59, and 30 to 44 ml/min/1.73 m2, respectively (P-trend < 0.001). After adjustment for age; race/ethnicity; sex; menopausal status; education; income; cigarette smoking; alcohol consumption; body mass index; hypertension; diabetes mellitus; vitamin D supplement use; total calorie and calcium intake; and serum calcium, phosphorus, and 25-hydroxyvitamin D levels - and compared with their counterparts with an eGFR ≥ 60 ml/min/1.73 m2 - the prevalence ratios of elevated iPTH were 2.30 and 4.69 for participants with an eGFR of 45 to 59 and 30 to 44 ml/min/1.73 m2, respectively (P-trend < 0.001). Serum phosphorus ≥ 4.2 mg/dl and 25-hydroxyvitamin D < 17.6 ng/ml were more common at lower eGFR levels. No association was present between lower eGFR and serum calcium < 9.4 mg/dl. Conclusions: This study indicates that elevated iPTH levels are common among patients with moderate CKD.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 186-194 |
| Number of pages | 9 |
| Journal | Clinical Journal of the American Society of Nephrology |
| Volume | 4 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2009 |
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ASJC Scopus subject areas
- Nephrology
- Transplantation
- Epidemiology
- Critical Care and Intensive Care Medicine
- Medicine(all)
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Association of serum intact parathyroid hormone with lower estimated glomerular filtration rate. / Muntner, Paul; Jones, Tiffany M.; Hyre, Amanda D.; Melamed, Michal L.; Alper, Arnold; Raggi, Paolo; Leonard, Mary B.
In: Clinical Journal of the American Society of Nephrology, Vol. 4, No. 1, 01.01.2009, p. 186-194.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association of serum intact parathyroid hormone with lower estimated glomerular filtration rate
AU - Muntner, Paul
AU - Jones, Tiffany M.
AU - Hyre, Amanda D.
AU - Melamed, Michal L.
AU - Alper, Arnold
AU - Raggi, Paolo
AU - Leonard, Mary B.
PY - 2009/1/1
Y1 - 2009/1/1
N2 - Background and objectives: The prevalence of mineral metabolism abnormalities is almost universal in stage 5 chronic kidney disease (CKD), but the presence of abnormalities in milder CKD is not well characterized. Design, setting, participants, & measurements: Data on adults ≥20 yr of age from the National Health and Nutrition Examination Survey 2003-2004 (N = 3949) were analyzed to determine the association between moderate declines in estimated GFR (eGFR), calculated using the Modfication of Diet in Renal Disease formula, and serum intact parathyroid hormone (iPTH) ≥ 70 pg/ml. Results: The geometric mean iPTH level was 39.3 pg/ml. The age-standardized prevalence of elevated iPTH was 8.2%, 19.3%, and 38.3% for participants with eGFR ≥ 60, 45 to 59, and 30 to 44 ml/min/1.73 m2, respectively (P-trend < 0.001). After adjustment for age; race/ethnicity; sex; menopausal status; education; income; cigarette smoking; alcohol consumption; body mass index; hypertension; diabetes mellitus; vitamin D supplement use; total calorie and calcium intake; and serum calcium, phosphorus, and 25-hydroxyvitamin D levels - and compared with their counterparts with an eGFR ≥ 60 ml/min/1.73 m2 - the prevalence ratios of elevated iPTH were 2.30 and 4.69 for participants with an eGFR of 45 to 59 and 30 to 44 ml/min/1.73 m2, respectively (P-trend < 0.001). Serum phosphorus ≥ 4.2 mg/dl and 25-hydroxyvitamin D < 17.6 ng/ml were more common at lower eGFR levels. No association was present between lower eGFR and serum calcium < 9.4 mg/dl. Conclusions: This study indicates that elevated iPTH levels are common among patients with moderate CKD.
AB - Background and objectives: The prevalence of mineral metabolism abnormalities is almost universal in stage 5 chronic kidney disease (CKD), but the presence of abnormalities in milder CKD is not well characterized. Design, setting, participants, & measurements: Data on adults ≥20 yr of age from the National Health and Nutrition Examination Survey 2003-2004 (N = 3949) were analyzed to determine the association between moderate declines in estimated GFR (eGFR), calculated using the Modfication of Diet in Renal Disease formula, and serum intact parathyroid hormone (iPTH) ≥ 70 pg/ml. Results: The geometric mean iPTH level was 39.3 pg/ml. The age-standardized prevalence of elevated iPTH was 8.2%, 19.3%, and 38.3% for participants with eGFR ≥ 60, 45 to 59, and 30 to 44 ml/min/1.73 m2, respectively (P-trend < 0.001). After adjustment for age; race/ethnicity; sex; menopausal status; education; income; cigarette smoking; alcohol consumption; body mass index; hypertension; diabetes mellitus; vitamin D supplement use; total calorie and calcium intake; and serum calcium, phosphorus, and 25-hydroxyvitamin D levels - and compared with their counterparts with an eGFR ≥ 60 ml/min/1.73 m2 - the prevalence ratios of elevated iPTH were 2.30 and 4.69 for participants with an eGFR of 45 to 59 and 30 to 44 ml/min/1.73 m2, respectively (P-trend < 0.001). Serum phosphorus ≥ 4.2 mg/dl and 25-hydroxyvitamin D < 17.6 ng/ml were more common at lower eGFR levels. No association was present between lower eGFR and serum calcium < 9.4 mg/dl. Conclusions: This study indicates that elevated iPTH levels are common among patients with moderate CKD.
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U2 - 10.2215/CJN.03050608
DO - 10.2215/CJN.03050608
M3 - Article
VL - 4
SP - 186
EP - 194
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
SN - 1555-9041
IS - 1
ER -