Analysis of the influencing factors of secondary hyperparathyroidism in patients with stage 5 chronic kidney disease maintenance hemodialysis based on propensity score matching method
Objective To explore the influencing factors of secondary hyperparathyroidism(SHPT)in patients with stage 5 chronic kidney disease(CKD)maintenance hemodialysis based on propensity score matching(PSM)method.Methods Clinical data of 100 patients with stage 5 CKD and maintenance hemodialysis in our hospital from Jan 2020 to May 2023 were retrospectively analyzed.The patients were divided into two groups based on the presence or absence concurrent SHPT:the SHPT group(n=39)and the non-SHPT group(n=61).The PSM method was used to match the SHPT group and the non-SHPT group,and a total of 37 pairs were matched.Logistic regression method was used to analyze the influencing factors of SHPT in stage 5 CKD maintenance hemodialysis patients.Results After matching,compared with the non-SHPT group,the SHPT group had a higher proportion of diabetes,primary diabetic nephropathy,and malnutrition(P<0.05),with increased levels of hs-CRP,serum phosphorus,and ALP(P<0.05).The proportion of hemodialysis combined with hemofiltration decreased(P<0.05),and the duration of maintenance hemodialysis was prolonged(P<0.05).Primary diabetic nephropathy(OR=1.861,95%CI:1.448～2.391),hs-CRP(OR=1.754,95%CI:1.320～2.331),blood phosphorus(OR=1.935,95%CI:1.373～2.726),ALP(OR=1.645,95%CI:1.260～2.148),malnutrition(OR=1.844,95%CI:1.276～2.666)and maintenance hemodialysis time(OR=1.883,95%CI:1.366～2.597)were the risk factors for SHPT in stage 5 CKD maintenance hemodialysis patients(P<0.05),hemodialysis combined with hemofiltration(OR=0.544,95%CI:0.424～0.700)were the protective factor for SHPT in stage 5 CKD maintenance hemodialysis patients(P<0.05).Conclusion According to the PSM method,the risk factors of SHPT in stage 5 CKD maintenance hemodialysis patients include primary diabetic nephropathy,hs-CRP,blood phosphorus,ALP,malnutrition and maintenance hemodialysis time.The protective factor is hemodialysis combined with hemofiltration.
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