To explore the clinical characteristics and related risk factors in patients with severe uremic secondary hyperparathyroidism (SHPT) complicated with Sagliker syndrome (SS).

A total of 229 patients with severe uremic SHPT admitted in our hospital from February 2011 to April 2015 were enrolled, among which 33 cases were taken as positive group (SS group), and 196 cases as control group. The differences between two groups in demographic data (such as gender and age), complications, and biochemical indexes were compared, with potential risk factors of SS being analyzed.

There were significant differences between median duration of dialysis in positive group (11 years) and that in control group (8 years, P <0.001). Compared to control group, the patients in SS group had lower levels of serum creatinine (Scr), blood urea nitrogen (BUN), albumin (Alb), phosphorus (P), and higher serum levels of parathyroid hormone (iPTH), ferritin, hypersensitive C-reactive protein and alkaline phosphatase (ALP), as well as higher calcification in heart valves and abdominal aortic (all P <0.05). The unadjusted logistic regression models showed that longer duration of dialysis (>10 years, OR=6.182, P=0.002), higher serum levels of ALP (>347 U/L, OR=5.786, P=0.002) and iPTH (>1764 ng/L, OR=4.960, P=0.001), and calcification in heart valves and abdominal aortic (OR=8.635, P <0.001; OR=5.039, P=0.001) were associated with increased risks of SS, and higher serum Alb was a protect factor for SS (OR=0.904, P=0.014). The multivariate regression analysis showed that longer duration of dialysis (>10 years, OR=5.121, P=0.036), higher serum level of iPTH (>1764 ng/L, OR=4.130, P=0.017), calcification in heart valves (OR=11.714, P <0.001) were independent risk factors of SS.

Severe uremic SHPT patients with longer duration of dialysis and higher serum level of iPTH are more likely to develop SS.

Kidney failure, chronic; Hyperparathyroidism, secondary; Risk factors; Sagliker syndrome