Prevalence and Morbidity of Severe Secondary Hyperparathyroidism in the Haemodialysis Population

Original article


Ezwaie MO 1, Geryo NM 1, Hussein SM 1, Shembish FM 2, Daghman AA 2, Turki SH 1

1-Department of Nephrology, Faculty of Medicine, 2- Department of Radiology, Faculty of Medicine, Arab University of Medical Sciences Benghazi, Libya

JMJ 2009;9(4):


Secondary hyperparathyroidism is a common complication of chronic kidney disease, and a frequent cause of clinically significant bone disease. In patient with chronic renal disease subset of patients, who manifest a severe form of this chronic complication, have soft tissue and vascular calcification, which are additional serious consequences of the disorder. A retrospective case-controlled study was conducted to address the magnitude of this problem, its associated risk factors, and morbidity in chronic haemodialysis patients. The hospital records of 248 prevalent haemodialysis patients, over two years (2005-2006) were reviewed, of which two groups were identified, based on their PTH level, group ( I ), 23 males, and 17 females, mean age 48.3±8.9 years, with PTH persistently elevated ( >800 pg/ml) mean PTH 1160±87 pg/ml, and a control group ( II ), 17 males and 14 females, mean age 44.5± 6.3 years, with stable PTH level mean PTH 236±30 pg/ml. The prevalence of secondary hyperparathyroidism was 17% (40 cases), with male to female ratio of 1.3: 1, hyperphosphataemia was recorded in 68% (27) of these hyperparathyroid patients. Tertiary hyperparathyroidism was observed in 3 cases (1.2%), all of male gender, with mean PTH level 2086±34 pg/ml. The risk factors contributing to development of severe secondary hyperparathyroidism were; persistent hyperphosphatemia, and early loss of residual renal function. The most remarkable associated morbidities in group (I) hyperparathyroid patients were; tertiary hyperparathyroidism, shorter survival of arterio-venous fistula, calciphylaxis, and aortic valve calcification.

Keywords: Chronic kidney disease, Secondary hyperparathyroidism, Hyperphosphatemia, Residual renal function, Arterio-venous fistula survival, Calciphylaxis, Aortic valve calcification.