血液透析患者继发性甲状旁腺功能亢进症中甲状旁腺激素与肾素-血管紧张素-醛固酮系统的关系。
Relationship between parathyroid hormone and renin-angiotensin-aldosterone system in hemodialysis patients with secondary hyperparathyroidism.
机构信息
Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
出版信息
J Bone Miner Metab. 2021 Mar;39(2):230-236. doi: 10.1007/s00774-020-01139-5. Epub 2020 Sep 12.
INTRODUCTION
Hyperparathyroidism (HPT) is associated with mortality and cardiovascular disease (CVD) in dialysis patients. However, its mechanism is still unclear. It is suspected that parathyroid hormone (PTH) is associated with the renin-angiotensin-aldosterone system (RAAS) as a possible mechanism. Thus, we examined their hormonal interaction in hemodialysis patients with secondary HPT.
MATERIALS AND METHODS
Seventeen hemodialysis patients with HPT were included. All patients underwent total parathyroidectomy (PTx). Serum intact PTH (iPTH), calcium and phosphate levels, plasma renin activity (PRA), and plasma aldosterone levels (ALD) were measured pre- and post-PTx.
RESULTS
Pre-serum iPTH tended to be correlated with pre-PRA and were significantly correlated with pre-ALD (pre-PRA: r = 0.44, p = 0.07, pre-ALD: r = 0.49, p < 0.05). With the reduction in serum iPTH after PTx, PRA and ALD significantly decreased after PTx. Additionally, the change in serum iPTH tended to be correlated with the changes in PRA and ALD (PRA; r = 0.46, p = 0.05, ALD; r = 0.45, p = 0.06).
CONCLUSION
Our results suggest that PTH could be interrelated with RAAS in hemodialysis patients with secondary HPT.
简介
甲状旁腺功能亢进症（HPT）与透析患者的死亡率和心血管疾病（CVD）有关。然而，其机制尚不清楚。有人怀疑甲状旁腺激素（PTH）与肾素-血管紧张素-醛固酮系统（RAAS）有关，这可能是其机制之一。因此，我们研究了继发性 HPT 血液透析患者中两者的激素相互作用。
材料与方法
纳入 17 例 HPT 血液透析患者。所有患者均行甲状旁腺全切除术（PTx）。于术前和术后检测血清全段甲状旁腺素（iPTH）、钙和磷水平、血浆肾素活性（PRA）和血浆醛固酮水平（ALD）。
结果
术前血清 iPTH 与术前 PRA 呈正相关，与术前 ALD 显著相关（术前 PRA：r=0.44，p=0.07；术前 ALD：r=0.49，p<0.05）。PTx 后血清 iPTH 降低，PRA 和 ALD 也随之显著降低。此外，血清 iPTH 的变化与 PRA 和 ALD 的变化呈正相关（PRA：r=0.46，p=0.05；ALD：r=0.45，p=0.06）。
结论
我们的研究结果表明，在继发性 HPT 血液透析患者中，PTH 可能与 RAAS 相互关联。
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