Relationships between blood phosphorus and parathyroid hormone levels and sleep disorders in maintenance hemodialysis patients

PAN Xiaoting; ZHANG Ziyu; WANG Xuejie; YANG Zhenhua; GAO Chenni; CHEN Xiaonong

doi:10.3969/j.issn.1002-266X.2025.01.004

Abstract：Objective To explore the relationships between blood phosphorus and parathyroid hormone(PTH)lev-els and the sleep disorders in patients undergoing maintenance hemodialysis(MHD).Methods Totally 100 patients un-dergoing maintenance hemodialysis were enrolled.Patients were divided into two groups according to the Pittsburg Sleep Quality Index(PSQI)scale:the good sleepers(n=29)and poor sleepers(n=71).Clinical data were compared between two groups,and Logistic regression analysis was performed to identify the effects of blood phosphorus and PTH on sleep dis-orders among MHD patients.The predictive value of blood phosphorus and PTH for sleep disorders in MHD patients was evaluated by the receiver operating characteristic(ROC)curve.Results The blood phosphorus and PTH levels were sig-nificantly higher in the poor sleepers than in the good sleepers(both P<0.05).Hyperphosphatemia(OR=3.85,95%CI=1.496-9.908)and elevated PTH(OR=1.003,95%CI=1.001-1.006)were independent risk factors for sleep disorders in MHD patients(both P<0.05).After adjusting gender and age,for every 1 mmol/L increase in blood phosphorus,the risk of sleep disorders increased by 4.082 times;for every 1 pg/mL increase in PTH,the risk of sleep disorders increased by 1.004 times.The area under the ROC curve of blood phosphorus and PTH in prediction of sleep disorders in MHD patients was higher than that of either alone(both P<0.05).Conclusion MHD patients with hyperphosphatemia and elevated PTH were prone to sleep disorders,and the combination of blood phosphorus and PTH had certain predictive value for the occurrence of sleep disorders in MHD patients.