Analysis Of Risk Factors Of Sagliker Syndrome In Severe Secondary Hyperparathyroidism Patients

Objective Secondary hyperparathyroidism(SHPT) is a common complication of chronic renal failure patients, The serious long-term SHPT can lead to Sagliker syndrome(SS), In addition to suffering common clinical manifestations of SHPT,such as bone pain, itching, muscle weakness, SS patients are characterized by mandibular swelling deformity, some showed obvious height retreat, skeletal deformities and other changes. All above creates a huge impact on patients’ psychological and physiological health. SS is a special type of severe SHPT. Morbidity and mortality of SS are significantly higher than the general chronic kidney disease(CKD) population, thus bring serious economic and social burde. Therefore, patients with SS should be more emphasized, early attention and standard treatment. The aim of this study is to investigate clinical characteristics and the risk factors in patients with severe SHPT of SS.Methods A total of 229 patients with severe uremic SHPT admitted in our hospital from February 2011 to April 2015 were enrolled, among which 33 cases were taken as positive group(SS group), and 196 cases as control group. The differences between two groups in demographic data(such as gender and age), complications, and biochemical indexes were compared, with potential risk factors of SS being analyzed.Results There were significant differences between median duration of dialysis in positive group(11 years) and that in control group(8 years, P<0.001). Compared to control group, the patients in SS group had lower levels of serum creatinine(Scr), blood urea nitrogen(BUN),albumin(Alb), phosphorus(P), and higher serum levels of parathyroid hormone(i PTH), ferritin, hypersensitive C-reactive protein and alkaline phospatase(ALP), as well as higher calcification in heart valves and abdominal aortic(all P<0.05). The unadjusted logistic regression models showed that longer duration of dialysis(>10 years, OR=6.182, P=0.002), higher serum levels of ALP(>347 U/L, OR=5.786, P=0.002) and i PTH(>1764 ng/L, OR=4.960, P=0.001), and calcification in heart valves and abdominal aortic(OR=8.635, P<0.001; OR=5.039, P=0.001) were associated with increased risks of SS, higher serum Alb was a protect factor for SS(OR=0.904, P=0.014). The multivariate regression analysis showed that longer duration of dialysis(>10 years, OR=5.121, P=0.036), higher serum level of i PTH(>1764 ng/L, OR=4.130, P=0.017), calcification in heart valves(OR=11.714, P < 0.001) were independent risk factors of SS.Conclusions Severe uremic SHPT patients with longer duration of dialysis and higher serum level of i PTH are more likely to develop SS.