TÁC ĐỘNG CỦA CƯỜNG CẬN GIÁP THỨ PHÁT TRONG ĐIỀU TRỊ THIẾU MÁU Ở BỆNH NHÂN LỌC MÁU CHU KỲ: NGHIÊN CỨU BỆNH CHỨNG

Abstract

Objective: The study aims to evaluate the effect of secondary hyperparathyroidism on the management of anemia in patients undergoing hemodialysis. Subjects and methods: A cross-sectional descriptive study was conducted on 120 end-stage renal disease patients undergoing hemodialysis at Can Tho City General Hospital from October 2022 to October 2023. The patients were divided into two groups: Group 1 consisted of patients with parathyroid hormone (PTH) levels ≤ 300 pg/mL, and group 2 consisted of patients with PTH levels > 300 pg/mL. Result: Regarding the general characteristics of the two groups, the results showed no statistically significant differences in age, gender, history of hypertension and diabetes as well as duration of dialysis. Simultaneously, the levels of CRPhs, ferritin, albumin, calcium and EPO dosage between the two groups showed no significant difference (p > 0.05). However, the group of patients with secondary hyperparathyroidism (PTH levels >300 pg/mL) had significantly lower red blood cell counts and Hb concentrations compared to the group with PTH ≤ 300 pg/mL (p<0.05). Additionally, this group exhibited significantly higher serum phosphate levels, calcium-phosphate product levels (Ca x P), and erythropoietin resistance index (ERI) compared to patients without secondary hyperparathyroidism, with p < 0.05. Serum PTH levels had a moderate negative correlation with Hb levels (r = - 0.528, p <0.001). Conclusions: Secondary hyperparathyroidism exacerbates anemia in patients undergoing regular hemodialysis and increases resistance to erythropoietin. Therefore, to effectively manage anemia in patients with end-stage renal disease, it is essential to control serum parathyroid hormone (PTH) levels.