The Prevalence of Secondary Hyperparathyroidism in Patients Undergoing Hemodialysis

Osteodystrophy is one of the long-term complications of chronic renal failure. It is expressed in two forms: low turn over, and high turn over. It is an important cause of morbidity in patients with renal failure. If it is diagnosed and managed properly, many problems of such patients can be resolved. In this study, we evaluated the prevalence of hyperparathyroidism in patients undergoing hemodialysis and its correlation with different factors. This study was an analytic, observational study that was done by cross-sectional method. We formatted a questionnaire for patients on hemodialysis who were enrolled in the study over a period of six months in Shaheed Sadoughi Hospital, Yazd, Iran. Fasting blood samples (5 – 10 mL) were drawn to measure the levels of parathyroid hormone (PTH), calcium, phosphorus, and alkaline phosphatase. Skull and wrist radiographies were also done and a radiologist evaluated them for hyperparathyroidism. In the 80 patients studied, the prevalence of hyperparathyroidism was 45% (36 patients). Forty-four patients were diabetic. Among different factors, hyperparathyroidism did not correlate with frequency and duration of dialysis, age, sex, familial history, diabetes, hypertension, bone pains, muscle weakness, purities, and level of calcium and phosphorus. But there was a significant relationship between hyperparathyroidism and alkaline phosphatase levels and radiologic findings. We can use alkaline phosphatase levels and/or radiographic changes for evaluation of renal osteodystrophy in patients undergoing hemodialysis and prevent the complications by early diagnosis and proper management.