The Correlative Analysis On Relevant Factors Of Chronic Kidney Disease With Secondary Hyperparathyroidism

Background：Secondary hyperparathyroidism(SHPT) is one of the most commoncomplication of a chronic kidney disease(CKD),and which is often easilyoverlooked.When CKD and SHPT be merged,Elevated parathyroid hormone(Parathyroid hormone, PTH) will further aggravate the body’s mineralmetabolism disorders, which can cause Multi-system disease include bone,cardiovascular system, nervous system, skin, etc.These complications basedCKD is a vicious circle of reciprocal causation, seriously affecting the qualityof life of patients.SHPT factors are in addition to the traditional sense of thecalcium and phosphorus metabolism,1.25-(OH)2D3decreased production, aswell as anemia, acidosis, and other non-traditional factors.A variety of factorscan cause SHPT aggravate or even multi-system damage by differentmechanisms. So, fully aware of the occurrence and development of relevantfactors to the CKD merge SHPT, strengthen the prevention and treatment ofelevated PTH, so early prevention, early detection, early treatment, especiallyimproving the quality of patients of end stage renal disease, which has a positive and important role.Object:The correlative analysis on relevant factors of chronic kidney diseasewith secondary hyperparathyroidismMethod:Select the498patients from nephropathy Division of Jilin university inJanuary2010to December2012for CKD, they are include74cases, withoutelevated PTH, and424patients with elevated PTH.In accordance with theconditions of the two groups of patients were analyzed, including age, primarydisease, sex, blood pressure (BP), serum creatinine (Scr), hemoglobin (Hb),carbon dioxide combining power (CO2CP), triglyceride (TG), cholesterol (TC),high density lipoprotein cholesterol (HDL-C), low density lipoproteincholesterol (LDL-C), high-sensitivity C-reactive protein (CRP), serum albumin(Alb), urinary protein, calcium, phosphorus, etc.clinical data and biochemicalparameters. Normal or near normal distribution of measurements weredescribed as (x±s),the two samples were compared using independent samples t-test; Skewed distribution of measurement data were describedMe(P25, P75), the samples were using Wilcoxon test; The count conductedchi-square test. Each data was using linear correlation analysis (Pearson relatedand Spearman correlation analysis), p<0.05was statistically significant, p<0.01significant statistical significance. The factors that may be relevant to SHPTwere using multivariable logistic regression analysis.Results:1.General clinical data: In498patients, the combined and elevated PTHwas424cases(85.14%), without elevated PTH was74patients(14.86%).Primary disease is primary glomerular disease, a total of267cases(53.61%), followed by diabetic nephropathy in83cases (16.67%), hypertensivenephropathy in44cases(8.84%), chronic interstitial nephritis in35cases(7.03%), polycystic kidney disease in17patients (3.41%), others in52cases (10.44%). And the male to female ratio is1.58:1. A merger of theelevated PTH gender differences between the two groups was statisticallysignificant (p<0.05). The overall age mostly middle-aged group of40-59years,the age difference and elevated PTH was no statistically significant (p>0.05). 2.Biochemical indicators: Between the two groups of Hb, BP, Scr, CO2CP,CRP, TG, TC, LDL-C, Ca, P and other indicators difference was statisticallysignificant (p<0.05). Between the two groups of HDL-C,Alb, urinary proteinand other indicators was no significant difference (p>0.05).3.Correlation: PTH increased with Scr, CRP, TG, TC, LDL-C, P and otherfactors were positively correlated (p<0.05), With Hb, CO2CP, Ca and otherfactors were negatively correlated (p<0.05).4.Multivariate analysis showed that Scr and P were independent riskfactors for the development of CKD merge SHPT (p<0.05).Conclusions:1.CKD patients with elevated PTH were varying degrees, and affected bya variety of risk factors. A variety of risk factors and SHPT were reinforcingeach other, which adding to the development of CKD merge SHPT.2.The P and Scr are the independent risk factors for chronic kidney diseasefor secondary hyperparathyroidism.