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Relation between intact parathyroid hormone and hemoglobin level in chronic kidney disease patients on hemodialysis

Background Chronic kidney disease (CKD) is associated with many kinds of metabolic changes caused by the kidney disease itself and by dialysis treatment. Secondary hyperparathyroidism is a major complication of CKD; it describes a complex alteration in bone and mineral metabolism that occurs as a direct result of CKD. In addition, anemia is a common complication of CKD. Aim The aim of this work was to assess the relation between level of intact parathyroid hormone (IPTH) and hemoglobin (Hb) level in CKD patients on hemodialysis with the difference between patients under erythropoietin (EPO) and without EPO. Patients and methods The present study was carried out on 40 patients and 10 healthy individuals as controls. Patients were classified into the following groups − group I included 30 patients with CKD on hemodialysis, which was further divided into the following: group Ia − 10 patients with anemia and under EPO hormone; group Ib − 10 patients with anemia and not receiving EPO hormone; and group Ic − 10 patients on hemodialysis without anemia. Group II included 10 patients with iorn deficiency anemia and without renal impairment. Group III included 10 healthy individuals as a control group matched for age and sex. Laboratory investigations such as IPTH, serum phosphorus, serum calcium, serum creatinine, blood urea, complete blood count, serum ferritin, and transferrin saturation were performed for all participants. Results There was a statistically significant negative correlation between IPTH and serum Hb in group I and the other two groups. Conclusion Increased level of IPTH level in chronic hemodialysis patients may cause resistant anemia to EPO therapy in spite of iron load in their blood.