Aims: We evaluated the relationship between iPTH levels and glycemic control in patients with diabetes and end stage renal disease (ESRD) on maintenance hemodialysis (MHD).
Methods: The study included 98 subjects with ESRD and type 2 diabetes aged 30-75 years who were on MHD. These were divided into two groups--patients with HbA1c >7.0 (53 mmol/mol) (poor glycemic control group) and patients with HbA1c <7.0 (53 mmol/mol) (good glycemic control group). All patients had been on regular bicarbonate haemodialysis for more than 6 months using polysulfone membrane dialyzer; 4 h per episode 3 times/week, with a dialysis fluid of 3.0 mEq/L of calcium concentration. 1-α-(OH)D3 and calcium carbonate were used routinely in all patients. The contribution of each relevant biological parameter to serum iPTH level was assessed using multiple regression test.
Results: Poor glycemic control was associated with reduced serum iPTH level and good glycemic control with higher serum iPTH. The serum HbA1c level was significantly correlated with the serum iPTH level (p=0.0003).
Conclusions: Glycemic control is a significant determinant of iPTH level in diabetic ESRD patients on MHD.
Keywords: Intact parathyroid hormone; Maintenance hemodialysis; Type 2 diabetes mellitus.
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