RELATIVE HYPOPARATHYROIDISM IN HEMODIALYSIS-PATIENTS

To clarify the incidence and contributing factors of hypoparathyroidis m in a hemodialysis (HD) population, 224 patients undergoing maintenan ce HD were investigated. They were divided into 4 groups according to their high-sensitive parathyroid hormone levels: extra-high (EH) group > 420,000 pg/ml; high (H) group 20,000-420,000 pg/ml; moderate (M) gr oup 4,500-20,000 pg/ml; low (L) group < 4,500 pg/ml. In group L, a 25- mg/kg deferoxamine (DFO) infusion test was undertaken to estimate alum inium (Al) accumulation. The distribution in each group was 42, 35, 12 and 11% for groups L, M, H and EH, respectively. Group-L patients wer e relatively older than those of the other groups. Diabetes was seen i n 20% of group-L patients, as opposed to no diabetes in groups H and E H. Among the 22 diabetics, 82% were in group L. 70% of group-L patient s showed a less than 50-mu g/l Al increment after the DFO infusion tes t. Bone mineral density (BMD) did not differ between the groups with r elative hypoparathyroidism (RHP = L) and background-matched non-RHP, e ither at the initiation of HD or the recent period, and the changes in BMD were comparable between the 2 groups. These results suggest that a considerable number of HD patients show RHP. Diabetes, but not Al ac cumulation, was considered to be one of the predisposing factors of RH P, Though the outcome of RHP will be aplastic bone disease (ABD) in HD patients, the clinical significance of ABD has not been fully evaluat ed. Further studies are required to clarify the precise mechanisms of RHP and the significance of ABD.