2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by GUPTA, A. Articles by DIVINE, G. W. Search for Related Content PubMed PubMed Citation Articles by GUPTA, A. Articles by DIVINE, G. W.

Race Is a Major Determinant of Secondary Hyperparathyroidism in Uremic Patients

AJAY GUPTA^*, LEE R. KALLENBACH, GERARD ZASUWA^* and GEORGE W. DIVINE

^* Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, Michigan
Department of Biostatistics and Research Epidemiology, Henry Ford Hospital, Detroit, Michigan

Correspondence to Dr. Ajay Gupta, Division of Nephrology (CFP-5), Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, Michigan 48202. Phone: 313-916-2708; Fax: 313-916-2554; E-mail: ajgupta{at}usa.net

In the general population, blacks have higher parathyroid gland mass and circulating parathyroid hormone (PTH) levels than whites. This may predispose black patients to more severe parathyroid disease when renal failure develops. Therefore, racial differences in the severity of uremic hyperparathyroidism were examined in a population of patients with endstage renal disease (ESRD). Among ESRD patients receiving hemodialysis or peritoneal dialysis, two or more values of intact PTH (immunoradiometric assay, pg/ml) obtained at least 90 d apart were available in 1270 prevalent cases (61.1% blacks, 51% males, and 31.1% diabetic), including 466 incident cases with onset of ESRD after 1993. Maximum PTH levels were analyzed as a function of race, gender, age, diabetic status, and levels of serum calcium, phosphorus, alkaline phosphatase, and aluminum. Using a stepwise multiple regression model, the determinants of maximum PTH in the order of their importance were black race, serum phosphorus, absence of diabetes, younger age, serum calcium, and female gender. The maximum PTH levels averaged 641.7 in blacks and 346.0 in whites after adjusting for age, gender, diabetic status, serum calcium, and phosphorus (P < 0.0001). In blacks compared with whites, the odds ratio (95% confidence interval) for adynamic bone disease (maximum PTH < 150 pg/ml) was 0.26 (0.17 to 0.41), whereas the odds ratio for hyperparathyroid bone disease (mean PTH > 500 pg/ml) was 4.4 (2.10 to 9.25). Race is a major independent determinant of uremic secondary hyperparathyroidism. Among ESRD patients, blacks may be at an increased risk for hyperparathyroid bone disease and whites for adynamic bone disease.

This article has been cited by other articles:

				O. Moranne, M. Froissart, J. Rossert, C. Gauci, J.-J. Boffa, J. P. Haymann, M. B. M'rad, C. Jacquot, P. Houillier, B. Stengel, et al. Timing of Onset of CKD-Related Metabolic Complications J. Am. Soc. Nephrol., January 1, 2009; 20(1): 164 - 171. [Abstract] [Full Text] [PDF]

				M. Wolf, J. Betancourt, Y. Chang, A. Shah, M. Teng, H. Tamez, O. Gutierrez, C. A. Camargo Jr., M. Melamed, K. Norris, et al. Impact of Activated Vitamin D and Race on Survival among Hemodialysis Patients J. Am. Soc. Nephrol., July 1, 2008; 19(7): 1379 - 1388. [Abstract] [Full Text] [PDF]

				A. Richter, M. K. Kuhlmann, E. Seibert, P. Kotanko, N. W. Levin, and G. J. Handelman Vitamin C deficiency and secondary hyperparathyroidism in chronic haemodialysis patients Nephrol. Dial. Transplant., June 1, 2008; 23(6): 2058 - 2063. [Abstract] [Full Text] [PDF]

				C. P. Kovesdy, S. Ahmadzadeh, J. E. Anderson, and K. Kalantar-Zadeh Obesity Is Associated with Secondary Hyperparathyroidism in Men with Moderate and Severe Chronic Kidney Disease Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 1024 - 1029. [Abstract] [Full Text] [PDF]

				C. Basile, C. Lomonte, L. Vernaglione, F. Casucci, D. Chimienti, A. Bruno, S. Cocola, E. A. Verrelli, and F. Cazzato A high body mass index and female gender are associated with an increased risk of nodular hyperplasia of parathyroid glands in chronic uraemia Nephrol. Dial. Transplant., April 1, 2006; 21(4): 968 - 974. [Abstract] [Full Text] [PDF]

				M. Teng, M. Wolf, E. Lowrie, N. Ofsthun, J. M. Lazarus, and R. Thadhani Survival of Patients Undergoing Hemodialysis with Paricalcitol or Calcitriol Therapy N. Engl. J. Med., July 31, 2003; 349(5): 446 - 456. [Abstract] [Full Text] [PDF]

				L. D. Quarles, D. J. Sherrard, S. Adler, S. J. Rosansky, L. C. McCary, W. Liu, S. A. Turner, and D. A. Bushinsky The Calcimimetic AMG 073 as a Potential Treatment for Secondary Hyperparathyroidism of End-Stage Renal Disease J. Am. Soc. Nephrol., March 1, 2003; 14(3): 575 - 583. [Abstract] [Full Text] [PDF]

				I. H. de Boer, I. Gorodetskaya, B. Young, C.-y. Hsu, and G. M. Chertow The Severity of Secondary Hyperparathyroidism in Chronic Renal Insufficiency is GFR-Dependent, Race-Dependent, and Associated with Cardiovascular Disease J. Am. Soc. Nephrol., November 1, 2002; 13(11): 2762 - 2769. [Abstract] [Full Text] [PDF]

				A. Gupta Renal bone disease in black dialysis patients: are algorithms developed for white dialysis patients valid? Nephrol. Dial. Transplant., July 1, 2001; 16(7): 1518 - 1519. [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673