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Racial differences in the relationship between high-normal 25-hydroxy vitamin d and parathyroid hormone levels in early stage chronic kidney disease / Diferenças raciais na relação entre níveis normais-elevados de 25-hidroxivitamina d e hormônio da paratireóide na doença renal crônica em estágio inicial
Winder, Marquita B.; Mason, Darius L.; Rangaswami, Janani; Asif, Arif; Cleveland Clinic Lerner CollegeVachharajani, Tushar J.; Mathew, Roy O..
Affiliation
  • Winder, Marquita B.; Columbia Veterans Affairs Health Care System. Columbia. US
  • Mason, Darius L.; Methodist Le Bonheur Healthcare. Memphis. US
  • Rangaswami, Janani; Einstein Medical Center. Philadelphia. US
  • Asif, Arif; Jersey Shore University Medical Center. Hackensack-Meridian School of Medicine. Neptune. US
  • Cleveland Clinic Lerner CollegeVachharajani, Tushar J.; Medicine of Case Western Reserve University. Glickman Urological & Kidney Institute. Cleveland Clinic Lerner CollegeVachharajani, Tushar J.. Cleveland. US
  • Mathew, Roy O.; Columbia Veterans Affairs Health Care System. Columbia. US
J. bras. nefrol ; 43(1): 34-40, Jan.-Mar. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1154647
Responsible library: BR1.1
ABSTRACT
ABSTRACT

Aim:

Current guidelines do not address between-person variability in markers of bone and mineral metabolism across subgroups of patients, nor delineate treatment strategies based upon such factors.

Methods:

A cross sectional study was carried out to analyze data from 20,494 United States Veterans and verify the variability of Vitamin D (25(OH)D) and parathyroid hormone (PTH) levels across race and stage of chronic kidney disease.

Results:

PTH levels were higher in Black Americans (BA) than White Americans (WA) at all levels of 25(OH)D and across eGFR strata. There was a progressive decline in PTH levels from the lowest (25(OH)D < 20) to highest quartile (25(OH)D >=40) in both BA (134.4 v 90 pg/mL, respectively) and WA (112.5 v 71.62 pg/mL) (p<0.001 for all comparisons).

Conclusion:

In this analysis, higher than normal 25(OH)D levels were well tolerated and associated with lower parathyroid hormone values in both blacks and whites. Black Americans had higher PTH values at every level of eGFR and 25(OH)D levels suggesting a single PTH target is not appropriate.
RESUMO
RESUMO

Objetivo:

as diretrizes atuais não abordam a variabilidade entre as pessoas nos marcadores do metabolismo ósseo e mineral em subgrupos de pacientes, nem traçam estratégias de tratamento com base em tais fatores.

Métodos:

realizamos um estudo transversal para analisar dados de 20.494 veteranos de guerra dos Estados Unidos e verificar a variabilidade nos níveis de vitamina D (25 (OH) D) e hormônio da paratireóide (PTH) entre a raça e o estágio da doença renal crônica.

Resultados:

os níveis de PTH foram maiores em americanos negros (AN) do que em americanos brancos (AB) em todos os níveis de 25 (OH) D e em todos os estratos de TFGe. Houve um declínio progressivo nos níveis de PTH do quartil mais baixo (25 (OH) D <20) para o quartil mais alto (25 (OH) D> = 40) em AN (134,4 v 90 pg/mL, respectivamente) e AB (112,5 v 71,62 pg/mL) (p <0,001 para todas as comparações).

Conclusão:

Nesta análise, níveis de 25 (OH) D acima do normal foram bem tolerados e associados a valores mais baixos do hormônio da paratireóide em negros e brancos. Os americanos negros tinham valores de PTH mais altos em todos os níveis de TFGe e 25 (OH) D, sugerindo que uma única meta de PTH não é apropriado.
Subject(s)


Full text: Available Collection: International databases Database: LILACS Main subject: Vitamin D Deficiency / Renal Insufficiency, Chronic Type of study: Practice guideline / Observational study / Prevalence study / Risk factors Limits: Humans Language: English / Portuguese Journal: J. bras. nefrol Journal subject: Nephrology Year: 2021 Document type: Article Affiliation country: United States Institution/Affiliation country: Columbia Veterans Affairs Health Care System/US / Einstein Medical Center/US / Jersey Shore University Medical Center/US / Medicine of Case Western Reserve University/US / Methodist Le Bonheur Healthcare/US

Full text: Available Collection: International databases Database: LILACS Main subject: Vitamin D Deficiency / Renal Insufficiency, Chronic Type of study: Practice guideline / Observational study / Prevalence study / Risk factors Limits: Humans Language: English / Portuguese Journal: J. bras. nefrol Journal subject: Nephrology Year: 2021 Document type: Article Affiliation country: United States Institution/Affiliation country: Columbia Veterans Affairs Health Care System/US / Einstein Medical Center/US / Jersey Shore University Medical Center/US / Medicine of Case Western Reserve University/US / Methodist Le Bonheur Healthcare/US
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