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Original ArticleOpen Access
Secondary Hyperparathyroidism and Risk Factors in Patients Undergoing Peritoneal Dialysis in a Tertiary Hospital
Suwan N 
Objective: Secondary hyperparathyroidism (SHPT) can lead to significant morbidity, mortality, and additional healthcare
resource utilization in chronic kidney disease. Since the introduction of continuous ambulatory peritoneal dialysis (CAPD)
policy for end stage renal disease patients in Thailand, no large studies have been conducted to examine parathyroid
dysfunction in these patients. The baseline prevalence data are highly required. The present study was conducted to determine
the prevalence of SHPT and the risk factors associated with this dysfunction in CAPD patients.
Material and Method: The authors analyzed data of 173 patients who received CAPD at a single center between October
2008 and October 2010. Clinical data and laboratory variables related to parathyroid function were obtained from each
patient. Hyperparathyroidism was diagnosed when serum intact parathyroid hormone (iPTH) level was above 300 pg/ml.
Variables predicting the development of hyperparathyroidism were calculated by univariate and multivariate logistic regression
analysis.
Results: Hyperparathyroidism was identified in 29.48% of the CAPD patients. Significantly lower serum calcium levels (p =
0.037), significantly higher serum phosphate levels (p = 0.016) and significantly greater serum alkaline phosphatase
concentrations (p = 0.029) were observed in the patients with hyperparathyroidism. By multiple regression analysis, the
duration on CAPD showed a significant positive correlation with iPTH (r = 0.359, p < 0.01) while the total corrected Ca
levels had a significant negative correlation with iPTH (r = -0.176, p = 0.023).
Conclusion: There is a high prevalence of hyperparathyroidism in the current Thai CAPD population. Duration on CAPD
and hypocalcemia are independent risk factors for the development of hyperparathyroidism.
Keywords: CAPD, Secondary hyperparathyroidism
resource utilization in chronic kidney disease. Since the introduction of continuous ambulatory peritoneal dialysis (CAPD)
policy for end stage renal disease patients in Thailand, no large studies have been conducted to examine parathyroid
dysfunction in these patients. The baseline prevalence data are highly required. The present study was conducted to determine
the prevalence of SHPT and the risk factors associated with this dysfunction in CAPD patients.
Material and Method: The authors analyzed data of 173 patients who received CAPD at a single center between October
2008 and October 2010. Clinical data and laboratory variables related to parathyroid function were obtained from each
patient. Hyperparathyroidism was diagnosed when serum intact parathyroid hormone (iPTH) level was above 300 pg/ml.
Variables predicting the development of hyperparathyroidism were calculated by univariate and multivariate logistic regression
analysis.
Results: Hyperparathyroidism was identified in 29.48% of the CAPD patients. Significantly lower serum calcium levels (p =
0.037), significantly higher serum phosphate levels (p = 0.016) and significantly greater serum alkaline phosphatase
concentrations (p = 0.029) were observed in the patients with hyperparathyroidism. By multiple regression analysis, the
duration on CAPD showed a significant positive correlation with iPTH (r = 0.359, p < 0.01) while the total corrected Ca
levels had a significant negative correlation with iPTH (r = -0.176, p = 0.023).
Conclusion: There is a high prevalence of hyperparathyroidism in the current Thai CAPD population. Duration on CAPD
and hypocalcemia are independent risk factors for the development of hyperparathyroidism.
Keywords: CAPD, Secondary hyperparathyroidism
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