Close association between parathyroid hormone and left ventricular function and structure in end-stage renal failure patients under maintenance hemodialysis.

OBJECTIVES

Cardiovascular risk factors are a significant burden in end-stage renal disease patients under hemodialysis and cardiovascular-related diseases are the leading cause of death among these patients and are responsible for almost half of all deaths in dialysis patients. In this study we aimed to consider the role of excess PTH in the development of left ventricilar hypertrophy (LVH) and LV ejection fraction in patients with end-stage renal disease under regular hemodialysis.

PATIENTS AND METHODS

This study is cross-sectional, and was done in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis treatment. Calcium, Phosphorus, Alkalin phosphatase and Intact PTH (iPTH) were measured. Hypertensive patients were stratified into three stages. The total of 73 patients (F=28, M=45) consisted of 58 non-diabetic hemodialysis patients (F=22, M=36) and 15 diabetic hemodialysis patients (F=6, M=9).

RESULTS

Significant inverse correlation of serum ALP with percent age of LV ejection fraction, marginal correlation of serum ALP with LVH and marginal correlation of serum iPTH with LVH were observed. Also significant inverse correlation of serum iPTH with percent age of LV ejection fraction in non diabetic HD patients was observed.

CONCLUSIONS

Adverse effects of secondary hyperparathyroidism on LV function and structure in this study show the role of excess PTH in the development of left ventricilar (LV) hypertrophy as well as low LV ejection fraction in patients with end-stage renal disease under hemodialysis which needs more attention to control of secondary hyperparathyroidism to reduce the risk of cardiovascular morbidity and mortality in dialysis patients. (Tab. 5, Fig. 3, Ref: 29.)