Abstract:
Objective To investigate the clinical significance of testing parathyroid hormone (PTH) in patients with ureteral calculi with hydronephrosis.
Methods A total of 128 patients with ureteral calculi with hydronephrosis who underwent PTH detection in Jinshan Hospital of Fudan University from November 2021 to November 2022 were retrospectively included. According to creatinine clearance rate, they were divided into renal function injury group and non-renal function injury group. The clinical characteristics were compared between the two groups. Binary logistic regression was used to analyze the related factors of renal function injury. Pearson method was used to analyze the correlation between PTH and renal function index. Receiver operating characteristic (ROC) curve was used to evaluate the value of PTH in predicting renal function injury.
Results In the 128 patients, 39 patients (30.5%) were with elevated PTH, and 38 patients (29.7%) were with renal function injury. PTH, serum creatinine (sCr) and blood urea nitrogen (BUN) levels in the renal function injury group were higher than those in the non-renal function injury (P < 0.05). Binary logistic multivariate regression analysis showed that elevated PTH (OR=1.495, 95 % CI 1.058-2.114, P=0.023) and elevated sCr (OR=1.035, 95% CI 1.013-1.058, P=0.002) were independent related factors of renal function injury. PTH level was positively correlated with sCr, BUN and UA levels (r values were 0.440, 0.462, 0.304, P < 0.001). ROC curve analysis showed that the area under curve (AUC) of PTH in the diagnosis of renal function injury was 0.587, the cut-off value was 88.5 pg/mL and the Youden index, specificity and sensitivity were 0.370, 75.8% and 61.3%, respectively.
Conclusions PTH has a certain correlation with renal function in patients with ureteral calculi and hydronephrosis, which is helpful to find renal function damage. However, PTH has limited value to diagnose renal function damage in these patients, and it is necessary to combine other indicators.