Intact Parathyroid Hormone in Egyptian Type 2 Diabetics with Chronic Hemodialysis: Impact of Glycaemic Control

Abstract

Osteodystrophy is one of the long-term haemodialysis complications. In diabetic end stage renal failure patients, it mainly occurs as an aplastic or low-turnover bone disease due to their low serum intact parathyroid hormone (iPTH) levels. The aim of the present study is to evaluate intact PTH level in in Egyptian type 2 diabetics with chronic hemodialysis and its relation to glycaemic control .patients. 140 Egyptian patients, their mean age was 60.4 ± 10.6 years were evaluated. They were maintained on regular hemodialysis (HD); 3 times/week, and the patients were divided into two groups according to primary kidney disease, diabetic (98 patients) and non-diabetic (42 patients) groups. Diabetic group was furtherly subdivided according to glycated hemoglobin to controlled (32 patients) and non-controlled diabetics (66 patients). Intact parathyroid hormone (iPTH), glycated hemoglobin (HbA1c), serum bone specific alkaline phosphatase, Albumin, Glucose, calcium, phosphorus and magnesium were estimated. Urea reduction ratio (URR) was estimated to evaluate the hemodialysis adequacy. The diabetic group had significantly lower values of iPTH and serum magnesium than non-diabetic group (p < 0.03 and p < 0.001 respectively). The uncontrolled diabetics had significantly lower values of iPTH, serum magnesium and serum albumin (p < 0.002, p < 0.002& p < 0.03 respectively) than the controlled group. The serum HbA1c levels were strongly correlated with the serum iPTH levels (P < 0.003). intact PTH was lower in diabetic hemodialysis patients; also, glycaemic control was associated with higher PTH levels.