Association of Secondary Hyperparathyroidism and Hyperkalemia in Hemodialysis-dependent Chronic Kidney Disease Patients

Abstract Introduction: Hyperparathyroidism secondary to chronic renal failure is a condition characterized by increased secretion of parathyroid hormone (PTH), secondary to hyperphosphatemia and hypocalcemia. In dialysis patients’ hyperkalemia is a frequent electrolyte disturbance that may result in various complications. Objectives: The study aimed to determine the association of secondary hyperparathyroidism (SHPTH) with hyperkalemia in hemodialysis patients. There is very little literature on the direct relationship of hyperparathyroidism with hyperkalemia. Materials and Methods: This is an observational study of hemodialysis patients visiting a university hospital for maintenance hemodialysis. Patients were randomly selected for the study who were visiting the Department of Nephrology for their regular maintenance hemodialysis program. Serum PTH analysis was done by chemiluminescence method. Serum potassium >5.5 mEq/L was considered hyperkalemia, and serum intact PTH (iPTH) >300 pg/mL was considered as SHPTH. Results: The study included 59 participants from dialysis-dependent chronic kidney disease patients. In this study, 64.4% of the participants were male and 35.6% were female. The mean age of the study group was 47.64 ± 13.042 years. 44.1% of the participants had hyperkalemia, and 43.1% of the participants had SHPTH. 89.7% of the patients with SHPTH had hyperkalemia. The mean serum potassium in the iPTH ≤300 pg/mL group was 4.50 mEq/L. The mean serum potassium in the iPTH >300 pg/mL group was 6.33 mEq/L. 90.9% of the participants in the group iPTH: ≤300 pg/mL had serum potassium: ≤5.5 mEq/L while 88.0% of the participants in the group iPTH: >300 pg/mL had serum potassium: >5.5 mEq/L. There was a strong positive correlation between iPTH and serum potassium, and this correlation was statistically significant (rho = 0.72, P ≤ 0.001). Conclusion: The present study shows a statistically significant association of iPTH (SHPTH) and serum potassium (hyperkalemia), and high iPTH is positively associated with hyperkalemia.