Neuropatía diabética en pacientes con o sin hiperparatiroidismo secundario, atendidos en el servicio de nefrología del Hospital José Carrasco Arteaga de marzo a diciembre del 2014, Cuenca, Ecuador.

Abstract

Introduction: Diabetic neuropathy is common in diabetic nephropathy patients (DNP), however there is no information if secondary hyperparathyroidism increase Diabetic Neuropathy frequency.

Objective: The aim of this study was to determine if there is a higher incidence of symptoms and signs of neuropathy in a group of DNP with hyperparathyroidism, compared with a control group.

Methods: This prospective observational case control study consisted of DNP with parathyroid hormone (PTH) levels <60 pg/ml, called control group (CG). The group of hyperparathyroidism (GH) was formed by DNP and PTH levels ≥60 pg/ml. Variables were: body mass index, duration of diabetes, presence of signs and symptoms of diabetic neuropathy measured by the Michigan University Test. Minimum sample was 60 cases in each group. The scale variables were compared with Student t test and the percentages with Chi2.

Results: There were 60 cases in each group, 35 men in CG (58.3%) versus 33 (55.0%) in the GH (P = 0.713). GC age was 67 ± 11.0 vs 72 ± 11 years of GH (P = 0.009); Glomerular filtration rate in GC 53.82 ± 25.13 and 35.34 ± 18.43 GH ml / min / 1.73m2 (P <0.001). PTH in the GC 38.02 ± 15.32 pg / ml in the GH 119.07 ± 84.33 pg / ml (P <0.001). GC neuropathy symptoms in 28.3%, 36.6% in the GH (P = 0.330). It neuropathy signs on the GC was 38.3% and 83.3% GH (P <0.001). Odds Ratio for GH to present signs neuropathy was 8.044 (95% CI 3.42 - 18.92).

Conclusion: In this group of patients, diabetic neuropathy was more prevalent in the group with secondary hyperparathyroidism.