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Relationship between intact parathyroid hormone and all-cause death, cardiovascular events, and ectopic calcification in patients with diabetic kidney disease: A retrospective study

  • Author Footnotes
    1 Mengyuan Li and Jiafen Cheng contributed equally to this paper.
    Mengyuan Li
    Footnotes
    1 Mengyuan Li and Jiafen Cheng contributed equally to this paper.
    Affiliations
    Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
    Search for articles by this author
  • Author Footnotes
    1 Mengyuan Li and Jiafen Cheng contributed equally to this paper.
    Jiafen Cheng
    Footnotes
    1 Mengyuan Li and Jiafen Cheng contributed equally to this paper.
    Affiliations
    Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
    Search for articles by this author
  • Jian Zhao
    Affiliations
    Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
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  • Wen Xue
    Affiliations
    Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
    Search for articles by this author
  • Hui Bao
    Affiliations
    Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
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  • Yaxiang Song
    Affiliations
    Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
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  • Ling Qin
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
    Search for articles by this author
  • Author Footnotes
    1 Mengyuan Li and Jiafen Cheng contributed equally to this paper.

      Highlights

      • iPTH levels were significantly related to clinical outcomes in DKD patients.
      • Ectopic calcification was a risk for clinical outcomes in DKD patients.
      • DKD patients with higher iPTH levels had increased ectopic calcification rate.
      • DKD patients with higher iPTH levels had shorter survival time.

      Abstract

      Aim

      We aimed to investigate the relationship between intact parathyroid hormone (iPTH) levels and all-cause death, cardiovascular events, and ectopic calcification in patients with diabetic kidney disease (DKD).

      Methods

      In this retrospective cohort study, we collected the clinical data of 508 patients with clinically diagnosed DKD. The primary and secondary outcomes were all-cause death or cardiovascular events and ectopic calcification, respectively. We used different regression methods to analyze the relationship between various clinical parameters and the two clinical outcomes.

      Results

      We found that iPTH was a risk factor for all-cause death and cardiovascular events (hazards ration [HR]: 2.817, 95% confidence interval [CI]: 1.045–6.562, P = 0.016). Meanwhile, diabetes duration (HR: 1.090, 95% CI: 1.045–1.138, P < 0.0001), triglycerides (TG) (HR: 1.254, 95% CI: 1.049–1.499, P = 0.013), and iPTH (HR: 1.954, 95% CI: 1.001–3.813, P = 0.049) were independent risk factors for ectopic calcification. In contrast to patients with lower iPTH levels (iPTH < 31.7 pg/mL), patients with higher iPTH levels (iPTH ≥ 31.7 pg/mL) had increased ectopic calcification rate (P = 0.002) and decreased survival time (P < 0.001).

      Conclusion

      In patients with DKD, higher iPTH levels were significantly related to worsen clinical outcomes.

      Keywords

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