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Parathyroidectomy Reduces Intradialytic Hypotension in Hemodialysis Patients with Secondary Hyperparathyroidism
- Source :
- Kidney & Blood Pressure Research, Vol 37, Iss 4-5, Pp 323-331 (2013)
- Publication Year :
- 2013
- Publisher :
- S. Karger AG, 2013.
-
Abstract
- Background: Secondary hyperparathyroidism is associated with vascular calcification and arterial stiffness in patients with end-stage renal disease. The aim of this study was to analyze the frequency of intradialytic hypotension (IDH) and cardiovascular function before and after parathyroidectomy (PTX) in maintenance hemodialysis patients. Methods: We compared predialytic and intradialytic blood pressure, left and right ventricular ejection fraction (LVEF and RVEF), and cardiothoracic ratio 1 month before PTX, and 6 and 12 months after PTX. IDH was defined as a decrease in systolic blood pressure ≥ 20 mmHg or a decrease in mean arterial pressure ≥ 10 mmHg. Results: At the time of PTX, the mean age of the patients was 57.4 ± 12.0 years, and the mean dialysis vintage was 12.2 ± 5.8 years. At baseline, 6 months, and 12 months after PTX, the average numbers of sessions disturbed by IDH during 13 dialysis sessions (1 month) were 6.4, 3.9 (p < 0.016 vs. baseline), and 4.0 sessions (p < 0.037 vs. baseline, p = 0.801 vs. 6 months), respectively. LVEF and RVEF were improved significantly after PTX. Furthermore, volume status was also improved, as evidenced by the significantly greater ultrafiltration volume and reduced cardiothoracic ratio. Conclusions: Hemodialysis patients with severe secondary hyperparathyroidism are more likely to achieve normotensive and euvolemic status after PTX, probably through improved heart function and reduced IDH episodes.
- Subjects :
- Male
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
Mean arterial pressure
medicine.medical_treatment
Blood Pressure
lcsh:RC870-923
Intradialytic hypotension
End stage renal disease
End-stage renal disease
Renal Dialysis
Internal medicine
lcsh:Dermatology
medicine
Humans
Dialysis
Aged
Parathyroidectomy
Ejection fraction
business.industry
General Medicine
Middle Aged
lcsh:RL1-803
lcsh:Diseases of the genitourinary system. Urology
medicine.disease
Secondary hyperparathyroidism
Blood pressure
lcsh:RC666-701
Nephrology
Cardiology
Arterial stiffness
Kidney Failure, Chronic
Female
Hyperparathyroidism, Secondary
Hemodialysis
Hypotension
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 14230143 and 14204096
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Kidney and Blood Pressure Research
- Accession number :
- edsair.doi.dedup.....4f1476eec3dbb8c5d0d5c08f36d93ae3