Parathyroid Hormone Level Changes Before and After Dialysis in Hemodialysis Patients

Short‒term Effects of Calcium and Phosphorus

Abstract

[Objectives] We measured the parathyroid hormone concentration (PTH) in hemodialysis (HD) patients before and after HD, and examined its relationship with the serum calcium concentration (Ca), serum phosphate concentration (P), and other factors. [Subjects] A total of 104 HD patients who were not using osteoporosis drugs. [Methods] Patients were divided into three groups based on the rate of change in intact PTH before and after HD. We examined the relationship between the rate of change in intact PTH before and after HD and Ca and P, HD history, and the use of medications to treat secondary hyperparathyroidism (SHPT). Multiple regression analysis was performed using intact PTH before and after HD as the objective variable. [Results] In 74 patients with a 20％ or greater decrease in intact PTH, Ca levels before HD were significantly lower. Four patients with a 50％ or greater increase in intact PTH (all were treated with Upasicalcet) had significantly higher Ca levels before HD, and a longer history of HD. Factors determining intact PTH both before and after HD were Ca, P, and HD history. [Conclusion] Intact PTH fluctuated before and after HD, and the influencing factors were Ca, P, and HD history. The group in which intact PTH decreased after HD had low Ca before HD, while the group in which intact PTH increased significantly had high Ca before HD and a long HD history.