Are PTH serum levels predictive of coronary calcifications in haemodialysis patients?

Background. Cardiac calcifications are a frequent occurrence in uraemic subjects and are probably connected to the increased cardiovascular mortality of haemodialysis patients. There is substantial support to the hypothesis that low levels of serum PTH in haemodialysis patients are associated with i...

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Published in:	Nephrology, dialysis, transplantation Vol. 22; no. 11; pp. 3262 - 3267
Main Authors:	Coen, Giorgio, Manni, Micaela, Mantella, Daniela, Pierantozzi, Andrea, Balducci, Alessandro, Condò, Stefano, DiGiulio, Salvatore, Yancovic, Lijljana, Lippi, Basilio, Manca, Simone, Morosetti, Massimo, Pellegrino, Luigi, Simonetti, Giovanni, Gallucci, Massimo Taccone, Splendiani, Giorgio
Format:	Journal Article
Language:	English
Published:	Oxford Oxford University Press 01-11-2007 Oxford Publishing Limited (England)
Subjects:	Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Biomarkers - blood Calcinosis - epidemiology calcium coronary score Cardiology. Vascular system chronic kidney disease Cohort Studies Coronary Disease - epidemiology Coronary heart disease Diabetic Nephropathies - therapy Emergency and intensive care: renal failure. Dialysis management Female haemodialysis Heart Humans Hypertension - epidemiology Intensive care medicine Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy low bone turnover Male Medical sciences Middle Aged Parathyroid Hormone - blood Predictive Value of Tests Renal Dialysis - adverse effects Risk Factors serum iPTH Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system haemodialysis low bone turnover chronic kidney disease serum iPTH calcium coronary score Kidney disease Human Urinary system disease Calcium Hemodialysis Inorganic element Extrarenal dialysis Renal failure Turnover Calcification
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Summary:	Background. Cardiac calcifications are a frequent occurrence in uraemic subjects and are probably connected to the increased cardiovascular mortality of haemodialysis patients. There is substantial support to the hypothesis that low levels of serum PTH in haemodialysis patients are associated with increased vascular and cardiac calcium deposits, due to decreased buffering capacity of bone in low turnover osteodystrophy. The present study has been carried out on a cohort of patients on haemodialysis, with exclusion of previously parathyroidectomized patients, with the aim to evaluate the association between PTH serum levels and coronary calcifications. Methods. The study has been carried out in a cohort of 197 haemodialysis patients. There were 133 males and 64 females. Twenty-two patients had diabetes mellitus. Average age was 58.6 ± 12.9 years. Patients were divided into groups of intact PTH levels, 0–150 (A), 150–300 (B), 300–600 (C) and >600 (D) pg/ml. Results. The values of coronary scores in the PTH groups were as follows: (A) 624.7 ± 939, (B) 866.4 ± 1080, (C) 1202.8 ± 1742.3 and (D) 1872.7 ± 2961.9. The difference between coronary calcium scores was significant (P < 0.01). A general linear model identified serum calcium and dialysis age as independent factors of calcium deposits in the high PTH group. Conclusions. No prominent association between low PTH serum levels and the severity of coronary calcium deposits in haemodialysis patients was found while increased levels of PTH, with special regard to very elevated levels, associated with more frequent hypercalcaemia and hyperphosphataemia, should be considered a major risk factor of coronary calcifications and cardiac events.
Bibliography:	ark:/67375/HXZ-HN5NQ48L-0 istex:FFEC921F4E93F53212BE83B11031D2C0B720F075 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0931-0509 1460-2385
DOI:	10.1093/ndt/gfm370