Xiao-Han Lu1,2, Meng-Si Li1, Yao-Yao Li1, Yan-Dan Zheng1, Xiao-Yan Wu1, Ping Gao1. 1. Department of Nephrology, Zhong Nan Hospital of Wuhan University, Wuhan, China. 2. Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Abstract
OBJECTIVES: The aim of this study was to investigate a possible association between changes in low parathyroid hormone (PTH) levels and cardiac function decline in maintenance hemodialysis (MHD) patients. METHODS: A total of 150 MHD patients were included and followed for 24 months. The enrolled patients were divided into 3 groups based on their PTH status at baseline and 24 months. Factors potentially involved in changes in the PTH level and cardiac function were compared using multivariate logistic regression analysis. RESULTS: At 24 months, the presence of low PTH levels increased by 26.7%. The main independent factors for low PTH levels were a low BMI, hemoglobin, and serum albumin and high serum calcium (p < 0.05). A persistently low PTH level at 24 months was associated with a decrease in the left ventricular ejection fraction (LVEF) and increase in valvular calcification (p < 0.05). Additionally, a decrease in PTH levels from normal or high to low values was associated with a decrease in LVEF and cardiac output (CO) and an increase in valvular calcification (p < 0.05). Furthermore, compared with those of the persistently low PTH level group, LVEF values were lower at 24 months in the group with a decrease from high/normal to low PTH level (p < 0.05). CONCLUSION: Persistently low PTH levels and changes in the PTH level from high/normal to low were associated with cardiac function decline in MHD patients. Moreover, a PTH level change from high/normal to low showed a stronger correlation with cardiac function decline.
OBJECTIVES: The aim of this study was to investigate a possible association between changes in low parathyroid hormone (PTH) levels and cardiac function decline in maintenance hemodialysis (MHD) patients. METHODS: A total of 150 MHD patients were included and followed for 24 months. The enrolled patients were divided into 3 groups based on their PTH status at baseline and 24 months. Factors potentially involved in changes in the PTH level and cardiac function were compared using multivariate logistic regression analysis. RESULTS: At 24 months, the presence of low PTH levels increased by 26.7%. The main independent factors for low PTH levels were a low BMI, hemoglobin, and serum albumin and high serum calcium (p < 0.05). A persistently low PTH level at 24 months was associated with a decrease in the left ventricular ejection fraction (LVEF) and increase in valvular calcification (p < 0.05). Additionally, a decrease in PTH levels from normal or high to low values was associated with a decrease in LVEF and cardiac output (CO) and an increase in valvular calcification (p < 0.05). Furthermore, compared with those of the persistently low PTH level group, LVEF values were lower at 24 months in the group with a decrease from high/normal to low PTH level (p < 0.05). CONCLUSION: Persistently low PTH levels and changes in the PTH level from high/normal to low were associated with cardiac function decline in MHD patients. Moreover, a PTH level change from high/normal to low showed a stronger correlation with cardiac function decline.
Authors: Roberto M Lang; Michelle Bierig; Richard B Devereux; Frank A Flachskampf; Elyse Foster; Patricia A Pellikka; Michael H Picard; Mary J Roman; James Seward; Jack S Shanewise; Scott D Solomon; Kirk T Spencer; Martin St John Sutton; William J Stewart Journal: J Am Soc Echocardiogr Date: 2005-12 Impact factor: 5.251
Authors: Christiane Drechsler; Diana C Grootendorst; Elisabeth W Boeschoten; Raymond T Krediet; Christoph Wanner; Friedo W Dekker Journal: Nephrol Dial Transplant Date: 2010-09-14 Impact factor: 5.992
Authors: Manuel Naves-Díaz; Jutta Passlick-Deetjen; Adrian Guinsburg; Cristina Marelli; Jose Luis Fernández-Martín; Diego Rodríguez-Puyol; Jorge B Cannata-Andía Journal: Nephrol Dial Transplant Date: 2010-05-31 Impact factor: 5.992
Authors: David A Drew; Daniel E Weiner; Hocine Tighiouart; Tammy Scott; Kristina Lou; Amy Kantor; Li Fan; James A Strom; Ajay K Singh; Mark J Sarnak Journal: Am J Kidney Dis Date: 2014-09-17 Impact factor: 8.860
Authors: Jaime L Natoli; Rob Boer; Brian H Nathanson; Ross M Miller; Silvia Chiroli; William G Goodman; Vasily Belozeroff Journal: BMC Nephrol Date: 2013-04-17 Impact factor: 2.388