Endokrynol Pol. 2021 May 19. doi: 10.5603/EP.a2021.0034. Online ahead of print.
ABSTRACT
Introduction Elevated serum parathormone (PTH) levels have been observed in acute kidney injury and are related to calcium-phosphate metabolism disturbance, decreased renal production of 1,25 dihydroxyvitamin D3, impaired renal PTH excretion and other renal-independent factors. There are no data regarding PTH concentration kinetics in critically ill patients undergoing continuous renal replacement therapies (CRRT) in an intensive care setting. The primary objective of this study was to investigate trends in PTH serum levels in critically ill patients with multiorgan failure, undergoing CRRT by performing periodic PTH measurements in the acute phase of critical illness. Material and methods Single center, prospective, observational study conducted in an mixed, university affiliated, intensive care unit. Critically ill patients were included who fulfilled all of the following criteria: respiratory failure; circulatory failure; acute kidney injury treated by CRRT; sequential organ failure assessment score (SOFA score) of 5 or more. Patients who met any of the following criteria were excluded: acute liver failure; hypercalcemia at admission (total calcium serum level > 10.6 mg/dl; total ionized calcium plasma level > 1.35 mmol/l); parathyroid gland disease, end-stage renal disease, patients undergoing therapeutic plasma exchange or extracorporeal membrane oxygenation procedures, aged under 18 years, pregnant, life expectancy after admission to the intensive care unit anticipated to be less than 72 hours as assessed by the investigator. Results Thirty patients met the inclusion criteria. A statistically significant change in PTH over time was observed (Friedman ANOVA; p=0.0001). The post-hoc test showed a statistically significant decrease in PTH: measurements 5-8 relative to measurement 1, measurements 4-8 relative to measurement 2 (p.
PMID:34010434 | DOI:10.5603/EP.a2021.0034
