Persistently Low Intact Parathyroid Hormone Levels Predict a Progression of Aortic Arch Calcification in Incident Hemodialysis Patients

Overview

Journal Clin Exp Nephrol

Publisher Springer

Specialty Nephrology

Date 2012 Jan 6

PMID 22218932

Citations 5

Authors

Harin Rhee

Sang Heon Song

Ihm Soo Kwak

Soo Bong Lee

Dong Won Lee

Eun Young Seong

Il Young Kim

Affiliations

Soon will be listed here.

Abstract

Background: Recent observational studies have found that low intact parathyroid hormone (iPTH) is related with mortality in hemodialysis patients and these findings may be considered to be the result of accelerated cardiovascular calcifications in adynamic bone disease. This study was aimed to determine the relationship between persistently low iPTH and aortic arch calcification (AAC) in incident hemodialysis patients.

Methods: From January 2004 to December 2008, a total of 94 incident hemodialysis patients were enrolled in this study. They were divided into three groups according to the changing patterns of iPTH during the first year of hemodialysis. ACC was scored on posterior-anterior plain chest X-rays using a specific scale at the initiation of dialysis and followed till May 2011.

Results: The median follow-up periods were 46.9 months. The prevalence of baseline AAC and its progression were the highest in the persistently low iPTH group. Also, all-cause mortality was the highest in this group. Age, baseline calcification score and persistently low iPTH independently contributed to the progression of calcification by multivariate logistic regression analyses (HR 1.083, 95% CI 1.023-1.147, P = 0.006; HR 3.320, 95% CI 1.023-10.789, P = 0.046; HR 5.207, 95% CI 1.027-26.412, P = 0.046, respectively). Also, mortality was relatively higher in calcification progressor compared to non-progressor (39.3, 18.2%, P = 0.030).

Conclusion: Persistently low iPTH was an independent risk factor for both AAC and mortality in incident hemodialysis patients.

Citing Articles

Association between serum intact parathyroid hormone and survival in dialysis patients.

Luo C, Bian X, Ji C, Wang H, Ma J, Zhong C Int Urol Nephrol. 2024; 57(3):1019-1028.

PMID: 39557805 DOI: 10.1007/s11255-024-04288-y.

Relationship between serum parathyroid hormone levels and abdominal aortic calcification in patients starting hemodialysis who have never taken calcium tablets, calcitriol, or vitamin D analogs.

He J, Sun X, Nie R, Zhao L Ren Fail. 2022; 44(1):1409-1416.

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Hemodialysis patients with low serum parathyroid hormone levels have a poorer prognosis than those with secondary hyperparathyroidism.

Yu Y, Diao Z, Wang Y, Zhou P, Ding R, Liu W Ther Adv Endocrinol Metab. 2020; 11:2042018820958322.

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Impact of Different Levels of iPTH on All-Cause Mortality in Dialysis Patients with Secondary Hyperparathyroidism after Parathyroidectomy.

Xi Q, Xie X, Zhang L, Zhang R, Xiao Y, Jin C Biomed Res Int. 2017; 2017:6934706.

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(18)F-fluoride positron emission tomography measurements of regional bone formation in hemodialysis patients with suspected adynamic bone disease.

Frost M, Compston J, Goldsmith D, Moore A, Blake G, Siddique M Calcif Tissue Int. 2013; 93(5):436-47.

PMID: 23995764 PMC: 3824308. DOI: 10.1007/s00223-013-9778-7.

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