Qin Xu, Shasha Wang, Qiuyue Xiong, Ning Wang, Yifeng Hu, Lei Yan, Huixia Cao, Fengmin Shao
Department of Nephrology, Henan Key Laboratory of Kidney Disease and Immunology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, China.
Department of Nephrology, Key Laboratory of Nephrology and Immunology, Henan Xinxiang Medical University and Henan Provincial People's Hospital, Henan, China.
Ann Med. 2025 Dec;57(1):2541080. doi: 10.1080/07853890.2025.2541080. Epub 2025 Aug 9.
The body of patients with chronic kidney disease (CKD)is in a state of microinflammation, which further aggravates the progression of CKD and the occurrence and development of its complications. The inflammatory state of the body is significantly increased in patients with secondary hyperparathyroidism of CKD.
Patients diagnosed with chronic kidney disease in the department of Nephrology of Henan Provincial People's Hospital were selected as the experimental group, and 58 normal subjects were selected as the control group. Collecting patient's Clinical date, whole blood of the experimental group and control group was collected, and hs-CRP was detected by enzyme-linked immunosorbent assay. Compare the differences in clinical indicators and serum hs-CRP between the two groups. Taking PTH and hs-CRP as dependent variables, correlation analysis was conducted to clarify the relationship between PTH and hs-CRP, and further curve fitting was carried out.
The levels of hemoglobin, total protein and albumin in CKD group were significantly lower than those in control group ( < 0.001). Alkaline phosphatase, creatinine, uric acid, Cyc and blood phosphorus in CKD group were higher than those in control group, and the values were 0.016, <0.001, <0.001, <0.001, <0.001, respectively. Blood calcium was lower than control group, < 0.001. The levels of hs-CRP in CKD group were significantly higher than those in control group, < 0.001. Serum PTH was positively correlated with serum hs-CRP ( = 0.299, = 0.002) in a normalized holistic analysis of CKD patients. In order to further clarify the correlation between PTH and hs-CRP, quadratic method was used to conduct curve fitting on PTH and hs-CRP and found that = 0.361, = 7.795, < 0.001. Quadratic method was used to quadratic curve fitting at PTH levels <600 pg/mL, <500 pg/mL, <400 pg/mL, <300 pg/mL and <200 pg/mL, respectively, and it was found that the corresponding = 0.281, = 4.158, < 0.001. = 0.292, = 4.397, < 0.001; = 0.546, = 18.456, < 0.001; = 0.415, = 7.471, < 0.001; = 0.403, = 5.220, < 0.001. It was found that there was no correlation between PTH and hs-CRP in hemodialysis patients and peritoneal dialysis patients. In order to exclude the influence of drug use on the statistical results, after excluding the patients who took over phosphorus binder and calcium binder, curve fitting method was used to find that PTH and CRP were correlated, in peritoneal dialysis group and hemodialysis group, = 0.953, = 39.913, < 0.001; = 0.448, = 3.391, = 0.010 respectively.
CKD patients have the lowest levels of inflammatory factors within a certain range of PTH.
慢性肾脏病（CKD）患者机体处于微炎症状态，这进一步加重了CKD的进展及其并发症的发生发展。CKD继发性甲状旁腺功能亢进患者机体的炎症状态显著升高。
选取河南省人民医院肾内科确诊为慢性肾脏病的患者作为实验组，选取58例正常受试者作为对照组。收集患者临床资料，采集实验组和对照组全血，采用酶联免疫吸附法检测超敏C反应蛋白（hs-CRP）。比较两组临床指标及血清hs-CRP的差异。以甲状旁腺激素（PTH）和hs-CRP为因变量进行相关性分析，明确PTH与hs-CRP之间的关系，并进一步进行曲线拟合。
CKD组血红蛋白、总蛋白和白蛋白水平显著低于对照组（<0.001）。CKD组碱性磷酸酶、肌酐、尿酸、胱抑素C（Cyc）和血磷高于对照组，P值分别为0.016、<0.001、<0.001、<0.001、<0.001。血钙低于对照组，P<0.001。CKD组hs-CRP水平显著高于对照组，P<0.001。在对CKD患者进行的标准化整体分析中，血清PTH与血清hs-CRP呈正相关（r=0.299，P=0.002）。为进一步明确PTH与hs-CRP之间的相关性，采用二次曲线法对PTH和hs-CRP进行曲线拟合，发现r=0.361，F=7.795，P<0.001。分别采用二次曲线法在PTH水平<600 pg/mL、<500 pg/mL、<400 pg/mL、<300 pg/mL和<200 pg/mL时进行二次曲线拟合，发现相应的r=0.281，F=4.158，P<0.001；r=0.292，F=4.397，P<0.001；r=0.546，F=18.456，P<0.001；r=0.415，F=7.471，P<0.001；r=0.403，F=5.220，P<0.001。发现血液透析患者和腹膜透析患者中PTH与hs-CRP无相关性。为排除药物使用对统计结果的影响，排除服用过磷结合剂和钙结合剂的患者后，采用曲线拟合方法发现腹膜透析组和血液透析组中PTH与CRP相关，r分别为0.953，F=39.913，P<0.001；r=0.448，F=3.391，P=0.010。
在一定PTH范围内，CKD患者炎症因子水平最低。
