Relationship between altered parathyroid hormone and bone fractures in hemodialysis patients

Villacorta Díaz M.; Guzmán-Ventura W. · Revista Colombiana de Nefrologia (2023) · DOI: 10.22265/acnef.10.3.700

Resumen

Background: Bone fractures in patients on dialysis are frequent and impose a high burden of disability and multimorbidity. They have been linked to mineral-bone disorders but its association with parathyroid hormone remains controversial. Purpose: To determine the relationship between altered parathyroid hormone (PTH) and bone fractures in hemodialysis patients. Methodology: A cross-sectional, analytical study was conducted in 250 hemodialysis patients attending Hospital Víctor Lazarte Echegaray from 2015 to 2020. Patients were classified according to whether their PTH was altered (PTH <150 or >300 pg/ml) and whether bone fractures were present. The association between altered PTH and the presence of bone fractures was determined using bivariate and multivariate analysis; the results are presented as odds ratio (OR) considering a significant p-value if <0.05. Results: 250 patients were evaluated in which 69 (27.6 %) had altered PTH, 181 (72.4 %) had normal PTH; likewise, 42 (16.8 %) had bone fractures and 208 (83.2 %) had no bone fractures. Of the 42 patients with bone fractures, 22 (52.4 %) had altered PTH and 20 (47.6 %) had normal PTH; of the 208 patients without bone fractures, 47 (22.6 %) had altered PTH and 161 (77.4 %) had normal PTH (p=0.001). Altered PTH was associated with the presence of bone fractures with OR: 3.77 (95 % CI: 1.90-7.49) in the bivariate analysis and with OR: 2.85 (95 % CI: 1.19-6.82) in the multivariate analysis. The covariates that were associated with the presence of bone fractures were being over 60 years (OR: 2.74, 95 % CI: 1.12-6.69) and having been on hemodialysis for more than 5 years (OR: 6.72, 95 % CI: 2.98-15.13). Conclusions: Altered parathyroid hormone is related with bone fractures in hemodialysis patients.

Instituciones: Universidad Privada Antenor Orrego