Changes in cardiovascular calcification after parathyroidectomy in patients with ESRD.
BACKGROUND
The effect of parathyroidectomy on vascular calcification in patients with end-stage renal disease has been a subject of interest for many years, although studies in this area have not been definitive. The purpose of this investigation is to determine changes in vascular calcification after subtotal parathyroidectomy by using fast-gated helical computed axial tomographic imaging to measure coronary and carotid artery calcification.


METHODS
Computed tomographic imaging was performed at baseline and in follow-up on 10 patients who had undergone subtotal parathyroidectomy and 10 reference patients who had not undergone parathyroidectomy.


RESULTS
Patients who underwent subtotal parathyroidectomy had a mean change in coronary calcification of -92.3 +/- 469/y, and reference patients had a mean change of +479 +/- 630/y (P = 0.03). The 2 parathyroidectomy patients with the highest baseline scores had significant declines in both coronary and carotid calcification.


CONCLUSIONS
In this study, subtotal parathyroidectomy is associated with a significant decrease in vascular calcification in 2 of 10 dialysis patients with high coronary artery calcium scores and stabilization in 7 of 10 patients with low baseline scores.
Bleyer
Anthony J
AJ
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. ableyer@wfubmc.edu
Burkart
John
J
Piazza
Michael
M
Russell
Gregory
G
Rohr
Michael
M
Carr
J Jeffrey
JJ
D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications* / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000379:methods; D006435:Renal Dialysis / Q000009:adverse effects; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome