The 2Nd Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China.
Sci Rep. 2023 Sep 22;13(1):15838. doi: 10.1038/s41598-023-43016-x.
Chronic kidney disease (CKD) is a prevalent pathological condition worldwide. Parathyroid hormone (PTH) is an important index related to bone metabolism in CKD patients and has not received enough attention. This study was performed to investigate the incidence and diagnostic rate of CKDin hospital as well as PTH testing and treatment for secondary hyperparathyroidism (SHPT) in patients with stage 3 to 5 CKD. The data of patients who visited Zhejiang Provincial People's Hospital from February 2006 to April 2022 were retrieved from the hospital database. All data were divided into three subgroups using PTH testing and SHPT treatment as major comparative indicators for analysis. The data were then analyzed for overall PTH testing, CKD incidence, and diagnostic rate. Among 5,301,391 patients, the incidence of CKD was 13.14%. The missed diagnosis rate for CKD was 65.76%. The total PTH testing rate was 1.22%, of which 15.37% of PTH testing was performed in patients with stage 3 to 5 CKD. The overall diagnosis rate of SHPT in patients with stage 3 to 5 CKD was 31.0%. The prophylactic medication rate was 7.4%, and the rate of post-diagnostic drug therapy was 22.2% in patients who underwent SHPT treatment. The high misdiagnosis rate and low PTH testing rate of CKD requires prompt attention from clinicians. SHPT treatment should be considered especially in patients with stage 3 to 5 CKD.
慢性肾脏病（CKD）是一种全球范围内普遍存在的病理状况。甲状旁腺激素（PTH）是 CKD 患者骨代谢的一个重要指标，但并未得到足够的重视。本研究旨在调查 3 至 5 期 CKD 患者中 CKD 的住院发病率、诊断率以及继发性甲状旁腺功能亢进症（SHPT）的 PTH 检测和治疗情况。从医院数据库中检索了 2006 年 2 月至 2022 年 4 月期间在浙江省人民医院就诊的患者数据。所有数据均根据 PTH 检测和 SHPT 治疗情况分为三个亚组进行分析，以作为主要比较指标。然后对总体 PTH 检测、CKD 发病率和诊断率进行数据分析。在 5301391 例患者中，CKD 的发病率为 13.14%。CKD 的漏诊率为 65.76%。总体 PTH 检测率为 1.22%，其中 3 至 5 期 CKD 患者的 PTH 检测率为 15.37%。3 至 5 期 CKD 患者中 SHPT 的总体诊断率为 31.0%。预防性药物治疗率为 7.4%，接受 SHPT 治疗的患者中药物治疗率为 22.2%。CKD 的高误诊率和低 PTH 检测率需要临床医生的关注。SHPT 治疗应尤其考虑用于 3 至 5 期 CKD 患者。
