P1015IMPACT OF DIABETIC DISEASE ON IPTH LEVELS IN DIALYSIS PATIENTS

Abstract

Abstract Background and Aims Mineral bone disease in dialysis patients is an important predictor of morbimortality.iPTH levels had been previously associated with different parameters, but not clearly to diabetic disease (DBT). We aim to analyze relationship between DBT and iPTH levels in a large cohort of dialysis patients from Fresenius Medical Care LatinAmerica (FMC LA). Method Prevalent dialysis patients (more than 90 days on renal replacement therapy) by November 2019 in FMC LA dialysis units (Argentina, Brasil, Chile, Colombia, Ecuador, Perú) were included into the dataset. We obtained demographic, treatment and laboratory data by November 2019. Patients were identified as DBT when DBT was informed as etiology of renal disease or any DBT related ICD10 code was recorded as comorbid condition into the database. Use of insulin, calcitriol, paricalcitol and cinacalcet was also obtained.To evaluate association between DBT and iPTH level, Student t test for independent samples was used. Kruskal-Wallis and Mann-Whitney tests were also performed as confirmatory non-parametric tests for iPTH. Categorical variables were compared using Chi Square test. Linear regression was used to predict iPTH and analyze association with DBT. All procedures were performed on IBM SPSS Statistics© 21. Results A total of 31,709 prevalent patients were included. DBT prevalence was 29.7%. Main differences found between DBT and non-DBT patients are shown in table 1: Linear regression model to predict iPTH showed variables associated with increase in iPTH: Ca, P, K, use of calcitriol, use of cinacalcet; while others were associated with decrease in iPTH: age, dialyzate Ca, Hb, glucose, albumin, use of calcium carbonate as supplementation and DBT (table 2): Conclusion In our population diabetic patients were older, showed higher male prevalence and higher rate of catheter use. Kt/V, Ca and P serum levels were slightly lower than non-diabetic, but not clinically significant.Remarkable differences in laboratory were higher glucose and lower K and alb in DBT. While these differences were expected and already known and well described, lower iPTH in DBT is not.Diabetic disease affects iPTH level independently from other factors increasing the risk for hypoparathyroidism. Those findings should be analyzed to determine if DBT should be considered as a different group when targeting in mineral bone disease or P-binder prescription.