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首页> 外文期刊>Nephron >Hypoparathyroidism potentiates cardiovascular complications through disturbed calcium metabolism: possible risk of vitamin D(3) analog administration in dialysis patients with end-stage renal disease.
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Hypoparathyroidism potentiates cardiovascular complications through disturbed calcium metabolism: possible risk of vitamin D(3) analog administration in dialysis patients with end-stage renal disease.

机译：甲状旁腺功能低下症通过钙代谢紊乱增强心血管并发症：终末期肾病的透析患者中​​维生素D（3）类似物给药的可能风险。

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BACKGROUND/AIM: Progressive cardiovascular calcification in dialysis patients with end-stage renal disease (ESRD) is a serious complication; however, the precise mechanism remains uncertain. We tested whether metabolic calcium abnormalities and hypoparathyroidism might have a correlation with cardiovascular complications in ESRD patients. METHODS: A series of 48 ESRD patients with cardiovascular diseases and/or congestive heart failure, aged 36-82 (61 +/- 12) years, 23 male and 25 female, were enrolled in this study. Serum total calcium (Ca, mmol/l), inorganic phosphate (mmol/l), and intact parathyroid hormone (iPTH, pg/ml) levels were determined in all cases. RESULTS: Organic heart disease was confirmed in 28 patients (58.3%), including 15 with coronary artery disease: 8 with aortic aneurysm, 8 with stenotic valvular heart disease, 9 with excessive mitral annular calcification, 3 with dialysis cardiomyopathy, and 7 with obstructive arterial disease. Serum iPTH measurement revealed hypoparathyroidism (iPTH <60) in 20 of 48 (41.7%) and hyperthyroidism (iPTH >/=200) in 13 of 48 (27.1%) subjects. The 20 patients with low iPTH had a higher prevalence of valvular heart disease, a higher total Ca level corrected for serum albumin (2.70 +/- 0.30 in low iPTH vs. 2.47 +/- 0.30 in normal iPTH, 2.35 +/- 0.20 in high iPTH, p = 0.003) and a higher tendency of vitamin D(3) analog use (65% in low iPTH vs. 33% in normal iPTH and 46% in high iPTH, p = 0.078). Moreover, corrected serum Ca exhibited a negative logarithmic correlation with serum iPTH: corrected Ca = -0.284x log (iPTH) + 3.021 (r = 0.637, p = 0.0001). Multiple logistic regression analysis revealed diabetes and hypoparathyroidism (iPTH <60) as risk factors for cardiovascular complications in ESRD. CONCLUSION: These results suggest that hypercalcemia and hypoparathyroidism in conjunction with vitamin D(3) use might play an important role in cardiovascular complications of chronic dialysis patients. Copyright 2000 S. Karger AG, Basel
机译：背景/目的：终末期肾脏病（ESRD）透析患者的进行性钙化是一种严重的并发症。但是，确切的机制仍然不确定。我们测试了代谢性钙异常和甲状旁腺功能低下是否可能与ESRD患者的心血管并发症相关。方法：本研究纳入了一系列48例心血管疾病和/或充血性心力衰竭的ESRD患者，年龄36-82岁（61 +/- 12）岁，男性23例，女性25例。在所有情况下均测定血清总钙（Ca，mmol / l），无机磷酸盐（mmol / l）和完整的甲状旁腺激素（iPTH，pg / ml）水平。结果：确诊为器质性心脏病的28例患者（58.3％），其中包括15例冠状动脉疾病：8例主动脉瘤，8例瓣膜性心脏病，9例二尖瓣环钙化过多，3例透析性心肌病和7例阻塞性心脏病动脉疾病。血清iPTH测量显示48名受试者中有20名（41.7％）的甲状旁腺功能减退（iPTH <60），48名受试者中有13名（27.1％）甲亢（iPTH> / = 200）。 20例iPTH较低的患者患瓣膜性心脏病的几率更高，经血清白蛋白校正的总Ca水平也较高（iPTH较低的患者为2.70 +/- 0.30，正常iPTH的患者为2.47 +/- 0.30，iPTH的患者为2.35 +/- 0.20高iPTH，p = 0.003）和使用维生素D（3）类似物的趋势更高（低iPTH为65％，正常iPTH为33％，高iPTH为46％，p = 0.078）。此外，校正后的血清Ca与血清iPTH呈负对数关系：校正后的Ca = -0.284x log（iPTH）+ 3.021（r = 0.637，p = 0.0001）。多元逻辑回归分析显示，糖尿病和甲状旁腺功能低下（iPTH <60）是ESRD心血管并发症的危险因素。结论：这些结果表明高钙血症和甲状旁腺功能低下症与维生素D（3）的使用可能在慢性透析患者的心血管并发症中起重要作用。版权所有2000 S. Karger AG，巴塞尔

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