| Introduction:Hyperparathyroidism is an impact factor for cardiovascular disease in dialysis patients. However, there are limited data pertaining the severity of hyperparathyroidism and cardiac function in dialysis patients. The purpose of present study was to explore the influence of severity of hyperparathyroidism on cardiac function in dialysis patients.Methods:The study design was a retrospective, parallel-group, cross-sectional cohort study. The enrolled patients were chronic dialysis patients either on hemodialysis or peritoneal dialysis in two hospitals. A total 106 subjects were recruited, men:women were 53:53. The comparable variables included blood levels of Ca, P, Ca-P product, iPTH and parameters of cardiac echography. The study subjects were stratified into two groups according to cutoff iPTH level 800 pg/mL.Results:In severe group, the mean age was 48.8 years, dialysis duration was 105.2 months, mean iPTH level was 1552.2 pg/mL. In mild group, the mean age was 50.4 years, dialysis duration was 33.0 months (P< 0.0001), and mean iPTH level was 353 pg/mL (P< 0.0001). The Ca/P profiles were Ca 2.6:2.2 mmol/L (P< 0.0001), P 2.1: 1.5 mmol/L (P< 0.0001), Ca-P product 5.4:3.4 (P< 0.0001). The significant variables in cardiac echography were left atrium diameter 43.1:34.3 mm (P< 0.0001), ejection fraction 64.6:59.3% (P= 0.031). The other variables including left ventricle end-systolic volume, end-diastolic volume, aortic root diameters, interventricular septum thickness were not statistical significance between two groups.Conclusion:The study showed the most impact on cardiac function in severe hyperparathyroidism in dialysis patients were ejection fraction and left atrium diameter. The clinical significance needs to be further investigated.Introduction:By 46 cases of secondary hyperparathyroidism observation of postoperative pathologic results.Analysis of different level segment parathyroid hormone level of the patient’s pathology results if there is a difference.Methods:Choose since September 2009-January 2012 surgery china-japan friendship hospital in Beijing during the period of 46 cases after parathyroidectomy tissue pathology morphological analysisPatients with preoperative testing data, according to the level of iPTH in three groups.A group iPTH< 1000pg/ml (n=13), B group iPTH1000pg/m1～2000pg/ml (n=22), C group iPTH>2000pg/ml (n=11); Dialysis age group 10 years for the industry Compare three groups of patients with different levels of iPTH parathyroid tissue pathological morphology and laboratory indexes and the relationship between the age of dialysis. The mean using SPSS 17 analysis, t test, single factor variance analysis, classification variables described using composition ratio, using chi-square test is compared between group; With P< 0.05 as the difference was statistically significant.Results:For three groups of patients before dialysis blood calcium 2.578±0.228mmol/1,2.586±0.214mmol/1,2.576±0.222mmol/L, serum phosphate, 2.182±0.398mmol/1,2.161±.0586mmol/l,846±0.466mmol/L, dialysis ages 114.62±61.154mouth,97.52±36.453mouth,130.82±52.780mouth. Statistical analysis of the results of blood calcium blood phosphorus and age of dialysis there was no significant difference (P>0.05) iPTH 748.31±260.17pg/ml,1525.95±339.2pg/ml7, 2554.91±520.53pg/ml, Each group had significant difference (P<0.001) alkaline phosphatase216.00±196.81mmol/l,463.45±363.35mmol/l,619.55±377.50mmol/l, There are significant differences between groups (P<0.05) Alkaline phosphatase between groups of average increase of iPTH and greatly increased, and the rise of iPTH are positively related.Pathological observation, in the three groups in old hemorrhage, eosinophilic cells, water clear cell, adenoid structure, areas of calcification and hemal wall calcification lesions.Under 10 years and more than 10 years of dialysis age comparison results calcification,the proportion of vessel wall calcification were 23.1% and 78.9% respectively, with significant difference between the two groups (P<0.001)Conclusion:IPTH levels were positively correlated with increased alkaline phosphatase; The level of iPTH and pathological results no statistical correlation; The duration of dialysis and the secondary hyperparathyroidism no relevance, calcification and vessel wall calcification and dialysis time show significant correlation. |
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