Relationship Between Parathyroid Hormone Levels And Protein Energy Wasting In Patients With Peritoneal Dialysis

ObjectiveTo investigate the relationship between parathyroid hormone level and protein energy wasting in patients with peritoneal dialysis.MethodsInformation on 111 patients receiving peritoneal dialysis（PD）at the Department of Nephrology,First Hospital of Shanxi Medical University from December 2021 to October2022 was collected according to inclusion and exclusion criteria.The patients in this study were divided into three groups according to their serum parathyroid hormone（i PTH）levels:low i PTH group（<150 pg/ml）,i PTH attainment group（150-300 pg/ml）,high i PTH group（>300 pg/ml）.The general data and biochemical indexes of the patients were collected systematically through clinical cases,and the anthropological indexes were measured using professional equipment.The above indexes and the incidence of protein energy Wasting（PEW）in the three groups were compared,and the correlation between different serum i PTH levels and PEW in PD patients was investigated using logistic regression.Results1.The prevalence of PEW was 49.5%（55/111）in 111 PD patients,with the highest incidence of PEW in the low i PTH group at 75%（21/28）,followed by the i PTH attainment group at 47.1%（16/34）and the lowest incidence of PEW in the high i PTH group at 36.7%（18/49）,with statistically significant differences（P<0.05）;2.Comparison of general data between the three groups:the age of patients in the low i PTH group was higher than that in the i PTH-compliant group and the high i PTH group,and the difference was statistically significant（P<0.05）;the age of patients on dialysis in the low i PTH group was lower than that in the i PTH-compliant group and the high i PTH group,and the difference was statistically significant（P<0.05）;there was no statistically significant difference in the gender of patients in the three groups（P>0.05）;3.In the comparison of laboratory indicators between the three groups,the patients in the low i PTH group had lower albumin（ALB）,prealbumin（PA）,total cholesterol（TC）,creatinine（Scr）,blood calcium(Ca²⁺),blood phosphorus(P^3-)and uric acid（UA）than those in the i PTH-compliant group and the high i PTH group,and the difference was statistically significant（P<0.05）;between the three groups,blood magnesium(Mg²⁺),triglycerides（TG）and alkaline phosphatase（UA）were lower than those in the i PTH-compliant group,and the difference was statistically significant（P<0.05）.TG)and alkaline phosphatase（ALP）were not statistically significant（P>0.05）;4.In the comparison of anthropological indicators between groups,the low i PTH group had lower BMI,mid-arm circumference（MAC）,mid-arm muscle circumference（MAMC）,grip strength,and fat mass than the i PTH compliant group and the high i PTH group,and the difference was statistically significant（P<0.05）;there was no statistical difference in deltoid skinfold thickness（TSF）between the three groups（P>0.05）;5.Using PEW as the dependent variable,after assigning values to PEW-related indicators,a univariate logistic regression analysis found that age,BMI,Ca,P,UA,and low i PTH were associated with the occurrence of PEW in PD patients;6.After including the indicators with P<0.05 in the one-way regression analysis into the multi-factor logistic regression analysis,it was found that:age,Ca,P,UA,and low i PTH were still influential factors for PEW in PD patients;7.ROC curve analysis:i PTH has some predictive value for PEW.The sensitivity and specificity of i PTH for patients with PD combined with PEW were 40.0%and 87.5%respectively when i PTH was 150 pg/m L.Conclusions:The incidence of PEW in PD patients is high;low i PTH levels in PD patients are closely related to the occurrence of PEW,and i PTH has predictive value for PEW.It is suggested that early intervention of low i PTH levels in PD patients may improve the occurrence of PEW in PD patients.