Article ; Online: Mental Effects of Excess Parathyroid Hormone in Hemodialysis Patients: A Possible Role for Parathyroid 2 Hormone Receptor?
2019 Volume 24, Issue 3, Page(s) 285–289
Abstract: Depression as measured by the kidney disease quality of life (KDQOL) form is known to be an independent risk factor for mortality dialysis patients. Excess parathyroid hormone (PTH) has long been associated with neuropsychiatric disturbances. Those ... ...
| Abstract | Depression as measured by the kidney disease quality of life (KDQOL) form is known to be an independent risk factor for mortality dialysis patients. Excess parathyroid hormone (PTH) has long been associated with neuropsychiatric disturbances. Those psychiatric complications are currently attributed to hypercalcemia with very little evidence; however, with the discovery of the parathyroid hormone 2 receptor (PTH2R) in the brain which can be activated by PTH, PTH2R might indicate a direct effect of PTH. As secondary and tertiary hyperparathyroidism is common in dialysis patients where the serum calcium is low or normal, we chose to investigate a possible relationship between PTH levels and depression in dialysis patients. This was a matched pair observational study with 10 patients with intact PTH values above 1000 pg/mL who were matched with 10 patients who had PTH values less than 400 pg/mL for the presence of diabetes, years on dialysis, duration of dialysis time, Kt/V, hemoglobin, and 25 OH vitamin D levels, as well as intravenous iron and erythropoietin administration. The Kidney Disease Quality of Life questionnaire (KDQOL-36) scores and patient Health Questionnaire scores were analyzed during that time. All variables underwent tests for normality and matched pair t-test. All subscales of the KDQOL-36 were worse in the high PTH group with the effect on daily life reaching P = 0.01 and the burden of disease and symptoms both reaching P = 0.02. PTH and PTH2R may be appropriate targets for investigations to improve the quality of life in hemodialysis patients. |
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| MeSH term(s) | Correlation of Data ; Cost of Illness ; Depression/diagnosis ; Depression/etiology ; Depression/metabolism ; Duration of Therapy ; Female ; Humans ; Hyperparathyroidism, Secondary/diagnosis ; Hyperparathyroidism, Secondary/etiology ; Kidney Failure, Chronic/epidemiology ; Kidney Failure, Chronic/metabolism ; Kidney Failure, Chronic/psychology ; Kidney Failure, Chronic/therapy ; Male ; Matched-Pair Analysis ; Middle Aged ; Parathyroid Hormone/blood ; Quality of Life ; Receptor, Parathyroid Hormone, Type 2/metabolism ; Renal Dialysis/methods ; United States/epidemiology |
| Chemical Substances | Parathyroid Hormone ; Receptor, Parathyroid Hormone, Type 2 |
| Language | English |
| Publishing date | 2019-09-11 |
| Publishing country | Australia |
| Document type | Journal Article ; Observational Study |
| ZDB-ID | 2119809-3 |
| ISSN | 1744-9987 ; 1091-6660 ; 1744-9979 |
| ISSN (online) | 1744-9987 |
| ISSN | 1091-6660 ; 1744-9979 |
| DOI | 10.1111/1744-9987.13429 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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