Low Parathyroid Levels tied to Peritonitis in Incident peritoneal dialysis patients

It was a single-center and retrospective study in 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018. Researchers categorized the patients into three groups by serum PTH levels as follows:

low-PTH group, PTH < 150 pg/mL;

middle-PTH group, PTH 150-300 pg/mL;

high-PTH group, PTH > 300 pg/mL.

Key findings of the study were:

♦ During a median follow-up of 29.5 months, the researchers noted that the incidence rate of peritonitis was 0.10 episodes per patient-year.

♦They also noted that gram-positive organisms were the most common causative microorganisms (36.2%), and a higher percentage of gram-negative organisms was observed in patients with low PTH levels.

♦ They found that low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels.

♦ Upon multivariate adjustment, they found lower PTH levels, as an independent risk factor for peritonitis episodes [hazard ratio 1.643].

The authors concluded, "The present study demonstrates that low PTH levels are independently associated with a higher risk of peritonitis incidence in incident PD patients. Our results support the importance of maintaining proper PTH levels. Physicians should pay more attention to the predictive value of PTH on infectious events in PD patients. Future large-scale studies should afford insights for understanding the potential mechanisms how PTH levels predict peritonitis incidence."

For further information:

https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-021-02241-0