{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:45:59Z","timestamp":1791895559232,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Wasting is a common complication of kidney failure that leads to weight loss and poor outcomes. Recent experimental data identified parathyroid hormone (PTH) as a driver of adipose tissue browning and wasting, but little is known about the relations among secondary hyperparathyroidism, weight loss, and risk of mortality in dialysis patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 42,319 chronic in\u2010centre haemodialysis patients from the Dialysis Outcomes and Practice Patterns Study phases 2\u20136 (2002\u20132018). Linear mixed models were used to estimate the association between baseline PTH and percent weight change over 12\u00a0months, adjusting for country, demographics, comorbidities, and labs. Accelerated failure time models were used to assess 12\u00a0month weight loss as a mediator between baseline high PTH and mortality after 12\u00a0months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline PTH was inversely associated with 12\u00a0month weight change: 12\u00a0month weight loss &gt;5% was observed in 21%, 18%, 18%, 17%, 15%, and 14% of patients for PTH\u00a0\u2265600\u00a0pg\/mL, 450\u2013600, 300\u2013450, 150\u2013300, 50\u2013150, and &lt;50\u00a0pg\/mL, respectively. In adjusted analyses, 12\u00a0month weight change compared with PTH 150\u2013299\u00a0pg\/mL was \u22120.60%, \u22120.12%, \u22120.10%, +0.15%, and +0.35% for PTH\u00a0\u2265600, 450\u2013600, 300\u2013450, 50\u2013150, and &lt;50\u00a0pg\/mL, respectively. This relationship was robust regardless of recent hospitalization and was more pronounced in persons with preserved appetite. During follow\u2010up after the 12\u00a0month weight measure [median, 1.0 (interquartile range, 0.6\u20131.7) years; 6125 deaths], patients with baseline PTH\u00a0\u2265600\u00a0pg\/mL had 11% [95% confidence interval (CI), 9\u201313%] shorter lifespan, and 18% (95% CI, 14\u201323%) of this effect was mediated through weight loss \u22652.5%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Secondary hyperparathyroidism may be a novel mechanism of wasting, corroborating experimental data, and, among chronic dialysis patients, this pathway may be a mediator between elevated PTH levels and mortality. Future research should determine whether PTH\u2010lowering therapy can limit weight loss and improve longer term dialysis outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.12722","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T16:04:38Z","timestamp":1622563478000},"page":"855-865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Secondary hyperparathyroidism, weight loss, and longer term mortality in haemodialysis patients: results from the DOPPS"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1704-4507","authenticated-orcid":false,"given":"Hirotaka","family":"Komaba","sequence":"first","affiliation":[{"name":"Division of Nephrology, Endocrinology and Metabolism Tokai University School of Medicine  Isehara Japan"},{"name":"The Institute of Medical Sciences Tokai University  Isehara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suguru","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Division of Clinical Nephrology and Rheumatology Niigata University Graduate School of Medical and Dental Sciences  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanobu","family":"Nomura","sequence":"additional","affiliation":[{"name":"Medical Affairs Department Kyowa Kirin Co., Ltd.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith P.","family":"McCullough","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Evenepoel","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation University Hospitals Leuven  Leuven Belgium"},{"name":"Laboratory of Nephrology, Department of Microbiology and Immunology KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Christensson","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Sk\u00e5ne University Hospital Lund University  Malm\u00f6 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