SECONDARY HYPERPARATHYROIDISM AMONG END STAGE RENAL DISEASE PATIENTS IN WEST BANK
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Date
2023-08-28
Authors
Osaid Fayez Marie
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Abstract
Background: SECOUNDARY HYPERPARATHYROIDISIM (SPHT) is one of the serious complications in renal failure patients, it occurs when there is imbalance in calcium and phosphorous homeostasis. It's a very important issue because it may lead to many complications such as cardiovascular disease soft tissue and vascular calcification.
Aim: This study aims to determine the prevalence of secondary hyperparathyroidism among end stage renal disease patients in the Palestinian West Bank dialysis centers,and to find if there is a factor that affects PTH levels, furthermore, to highlight hyperparathyroidism widespread for nephrologists to minimize complications that may happen due to hyperparathyroidism.
Methodolgy: This descriptive study was conducted and a cross-sectional design retrospective was used by reviewing patients' medical records for Patients who are receiving dialysis (peritoneal & hemodialysis) in 10- kidney units distributed in different areas in the West Bank of Palestine. Independent T- test used to compare mean and Pearson test were used in the analysis by SPSS to find the correlation.
Results: The study results revealed that 65.1% of the patients have PTH level more than 300 pg/ml, with mean of 602.8 pg/ml ± 551. It also found the mean of calcium was 8.8 mg/dl±1and the mean of phosphorous was 6.5 mg/dl. Regarding the patients with diabetic the results found that 29.7% of them their PTH test was higher than 300 pg/ml level and non diabetic 35.4% and found that non diabetic patients have PTH level more than diabetic according to independent T- test. 39.9 % of males have a PTH level of more than 300 pg/ml meanwhile 25.2 % of females have the same level.20.3% of participants have serum calcium less than 8 mg/dl, and 19.9 % have a serum calcium level of more than 9.5 mg/d, 39.6 % of participants hyperphosphatemia, independent T - test indicated that there was no difference between gender in PTH level. Patients on dialysis for more than 5 years have a PTH level more than patients with less than 5 years of adherence to dialysis also by using independent T –test also, age didn’t have any influence on PTH level. found a negative relationship with a significant difference between PTH level and weight. There is a negative relationship between ferritin and PTH levels with no significant difference for the sample and a significant difference for the patient who has a PTH level of more than 600 pg/ml. Finally, the negative relationship between HGB and PTH levels showed with a significant difference.
Conclusion: SHPT is a very serious problem in ESRD patients which might lead to many complication as of life-threatening complications. Among the hemodialysis population, SHPT is common, which may increase the impact on the patients, patient's relatives, and healthcare professionals. All measures must be taken such as early detection measures to reduce this complication, dialysis adherence and consultation to nephrology care guidelines, inspire patients to follow them often and adhere to their prescribed medications routine laboratory testing, as well as early controlling of anticipated complications.
Keywords: Chronic Kidney Disease; End- Stage Renal Disease; Parathyroid Hormone; Secondary Hyperparathyroidism.