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The role of secondary hyperparathyroidism in left ventricular hypertrophy of patients under chronic hemodialysis

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The role of secondary hyperparathyroidism in left ventricular hypertrophy of patients under chronic hemodialysis

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Título The role of secondary hyperparathyroidism in left ventricular hypertrophy of patients under chronic hemodialysis
Autor Randon, Roseli Beatriz
Rohde, Luis Eduardo Paim
Comerlato, Liriane
Ribeiro, Jorge Pinto
Manfro, Roberto Ceratti
Abstract End-stage renal disease (ESRD) patients frequently develop structural cardiac abnormalities, particularly left ventricular hypertrophy (LVH). The mechanisms involved in these processes are not completely understood. In the present study, we evaluated a possible association between parathyroid hormone (PTH) levels and left ventricular mass (LVM) in patients with ESRD. Stable uremic patients on intermittent hemodialysis treatment were evaluated by standard two-dimensional echocardiography and their sera were analyzed for intact PTH. Fortyone patients (mean age 45 years, range 18 to 61 years), 61% males, who had been on hemodialysis for 3 to 186 months, were evaluated. Patients were stratified into 3 groups according to serum PTH: low levels (<100 pg/ml; group I = 10 patients), intermediate levels (100 to 280 pg/ml; group II = 10 patients) and high levels (>280 pg/ml; group III = 21 patients). A positive statistically significant association between LVM index and PTH was identified (r = 0.34; P = 0.03, Pearson’s correlation coefficient) in the sample as a whole. In subgroup analyses, we did not observe significant associations in the low and intermediate PTH groups; nevertheless, PTH and LVM index were correlated in patients with high PTH levels (r = 0.62; P = 0.003). LVM index was also inversely associated with hemoglobin (r = -0.34; P = 0.03). In multivariate analysis, after adjustment for age, hemoglobin, body mass index, and blood pressure, the only independent predictor of LVM index was PTH level. Therefore, PTH is an independent predictor of LVH in patients undergoing chronic hemodialysis. Secondary hyperparathyroidism may contribute to the elevated cardiovascular morbidity associated with LVH in ESRD.
Contido em Brazilian journal of medical and biological research. Ribeirão Preto, SP. Vol. 38, no. 9 (Sept. 2005), p. 1409-1416
Assunto Ecocardiografia
Hipertrofia ventricular esquerda
Hormônio paratireóideo
Insuficiência renal
[en] Echocardiography
[en] End-stage renal failure
[en] Left ventricular hypertrophy
[en] Parathyroid hormone
Origem Nacional
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/21178
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