Relationship between parathyroid hormone and serum creatinine levels in chronic kidney disease patients

Abstract

Background: Chronic kidney disease (CKD) is a chronic and progressive disease characterized by renal dysfunction due to the decrease of the glomerular filtration rate (GFR). Hyperparathyroidism—an elevation of parathyroid hormone (PTH) is a complication of CKD. Objective of the study: The present study is a retrospective study focussed on the relationship between PTH levels and serum creatinine/ GFR in CKD patients based on OP follow up. Materials and methods: The present study included 150 subjects who have been diagnosed as CKD and 80 normal subjects at Department of Laboratory services, Krishna Institute of Medical Sciences, Secunderabad, India. The CKD population included both males (75) and females (75) and the normal population included both males (40) and females (40) with an age group between 22 years and 87 years. The measurements of creatinine and PTH are done on the serum in Unicel DXC860i fully automated random access analyser by Modified Jaffe’s method traceable to IDMS. PTH is analysed by CLIA method. The GFR is calcutated by MDRD formula and using creatinine measured in serum. Results: The main finding in the study was a significant positive correlation between PTH and creatinine in CKD patients when compared to normal patients.We observed a significant rise in the PTH values with an increase in creatinine values and the increase in PTH is statistically higher in females(r=0.121, p<0.001) when compared to males (r=0.557, p<0.0001) in CKD patients. While in normal population the correlation between PTH and creatinine was insignificant, females (r=0.06, p<0.0001) and a significant negative correlation was observed between PTH and creatinine in males (r =-0.22, p<0.0001). Conclusion: Hyperparathyroidism is one of the earliest manifestations of impaired renal function.Monitoring trends is important for the detection and treatment of Chronic Kidney Disease. In these patients, it is reasonable to base the frequency of PTH monitoring on the presence and magnitude of abnormalities and rate the progression of disease. Progressive increases of PTH should be avoided and marked changes in PTH levels should trigger interventions with relatively simple treatments that have the potential to prevent adverse outcomes. Keywords: Parathyroid hormone; serum creatinine; chronic kidney disease