The clinical diagnosis value of parathyroid hormone and bone transport indexes detection in renal osteodystrophy in maintenance hemodialysis patients

Abstract

Objective To investigate the clinical diagnosis value of parathyroid hormone and bone transport indexes detection in renal osteodystrophy in maintenance hemodialysis (MHD) patients.Methods Seventy-six cases of MHD patients were selected as observation group,and 60 cases of healthy people were selected as control group.Serum intact parathyroid hormone (iPTH),parathyroid hormone 7-84 (PTH7-84),bone alkaline phosphatase (BALP) and osteocalcin (OC) were detected by enzyme-linked immunosorbent assay,and iPTH/PTH7-84 was calculated.Results Urea nitrogen,creatinine,phosphorus,alkaline phosphatase,BALP,iPTH,PTH7-84 and OC in observation group were significantly higher than those in control group (P ＜ 0.01 or ＜ 0.05).But calcium and albumin levels in observation group were significantly lower than those in control group (P ＜ 0.01).There was positive correlation between iPTH and BALP,OC,PTH7-84 (r =0.419,0.457,0.662;P ＜ 0.01);and there was positive correlation between PTH7-84 and BALP,OC (r =0.358,0.312;P ＜ 0.01).In observation group,the patients were divided into ＜ 300 ng/L group (36 cases) and ≥ 300 ng/L group (40 cases) according to the levels of iPTH.The age in ＜ 300 ng/L group was significantly higher than that in ≥300 ng/L group [(69.6 ± 11.2) years vs.(59.4 ± 10.1) years,P＜ 0.05].OC and BALP levels in ＜ 300 ng/L group were (9.32 ± 2.03) ng/L and (14.55 ± 9.01) U/L,and those in ≥300 ng/L group were (10.49 ± 2.76) ng/L and (23.81 ± 15.92) U/L,and there were significant differences between the 2 groups (P＜0.01 or ＜0.05).iPTH/PTH7-84 in ＜300 ng/L group was 0.57 ± 0.39,and that in ≥300 ng/L group was 1.12 ±0.58,and there was significant difference between the 2 groups (P ＜ 0.01).Conclusion Detection of serum BALP,OC,iPTH and PTH7-84 can reflect the actual situation of bone transport in MHD patients,and differentiate the type of renal osteodystrophy,which is a non-invasive diagnosis indicator of renal osteodystrophy and could be used to guide clinical treatment. Key words: Renal dialysis; Parathyroid hormone; Renal osteodystrophy