Pizzarelli F, Fabrizi F, Postorino M, Curatola G, Zoccali C, Maggiore Q
Nephrology Unit, National Research Council, Reggio Calabria, Italy.
Nephron. 1993;63(4):384-9. doi: 10.1159/000187239.
To assess whether parathyroidectomy (PTx) affects blood pressure (BP) in hemodialysis (HD) patients, we studied 11 uremics on HD treatment for 8.2 +/- 0.9 years who underwent successful PTx. As the control group, we selected 11 HD patients not submitted to PTx, matched with the study group for sex, age, years on HD, dialysis procedure and BP values. In the controls, BP and body weight did not change during the 2 years of observation. In the patients, BP remained stable in the year before PTx. PTx caused a progressive reduction in BP in 7 of the 11 patients. The fall was significant from the 3rd quarter onward (mean BP values before PTx: 139/82 mm Hg, 1 year after PTx: 122/75 mm Hg). The magnitude of the hypotensive effect of PTx was related to the pre-PTx systolic BP value (r = -0.70, p = 0.016). PTx also caused a significant progressive increase in body weight (1.56 +/- 0.57 kg 1 year after PTx). In conclusion, PTx causes BP fall in HD patients regardless of whether their preintervention values are normal or increased. The BP reduction occurs in concomitance with a consistent increase in body weight. BP variations are clinically relevant and may be related to the post-PTx calcium efflux from the vessel wall.
为评估甲状旁腺切除术（PTx）是否会影响血液透析（HD）患者的血压（BP），我们研究了11例接受HD治疗8.2±0.9年且成功接受PTx的尿毒症患者。作为对照组，我们选择了11例未接受PTx的HD患者，在性别、年龄、HD治疗年限、透析程序和血压值方面与研究组进行匹配。在对照组中，血压和体重在2年的观察期内未发生变化。在患者中，PTx前一年血压保持稳定。PTx使11例患者中的7例血压逐渐降低。从第3季度起下降显著（PTx前平均血压值：139/82 mmHg，PTx后1年：122/75 mmHg）。PTx的降压效果大小与PTx前收缩压值相关（r = -0.70，p = 0.016）。PTx还导致体重显著逐渐增加（PTx后1年增加1.56±0.57 kg）。总之，PTx会使HD患者血压下降，无论其干预前血压值是正常还是升高。血压降低与体重持续增加同时发生。血压变化具有临床相关性，可能与PTx后血管壁钙外流有关。
