title: Are PTH serum levels predictive of coronary calcifications in haemodialysis patients?
abstract: BACKGROUND
  Cardiac calcifications are a frequent occurrence in uraemic subjects and are probably connected to the increased cardiovascular mortality of haemodialysis patients. There is substantial support to the hypothesis that low levels of serum PTH in haemodialysis patients are associated with increased vascular and cardiac calcium deposits, due to decreased buffering capacity of bone in low turnover osteodystrophy. The present study has been carried out on a cohort of patients on haemodialysis, with exclusion of previously parathyroidectomized patients, with the aim to evaluate the association between PTH serum levels and coronary calcifications.
  
  
  METHODS
  The study has been carried out in a cohort of 197 haemodialysis patients. There were 133 males and 64 females. Twenty-two patients had diabetes mellitus. Average age was 58.6 +/- 12.9 years. Patients were divided into groups of intact PTH levels, 0-150 (A), 150-300 (B), 300-600 (C) and >600 (D) pg/ml.
  
  
  RESULTS
  The values of coronary scores in the PTH groups were as follows: (A) 624.7 +/- 939, (B) 866.4 +/- 1080, (C) 1202.8 +/- 1742.3 and (D) 1872.7 +/- 2961.9. The difference between coronary calcium scores was significant (P < 0.01). A general linear model identified serum calcium and dialysis age as independent factors of calcium deposits in the high PTH group.
  
  
  CONCLUSIONS
  No prominent association between low PTH serum levels and the severity of coronary calcium deposits in haemodialysis patients was found while increased levels of PTH, with special regard to very elevated levels, associated with more frequent hypercalcaemia and hyperphosphataemia, should be considered a major risk factor of coronary calcifications and cardiac events.
authors.affiliation: Ospedale Israelitico, TorVergata Hospital, Rome, Italy. giorgio.coen@fastwebnet.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Coen
authors.forename: Micaela
authors.initials: M
authors.lastname: Manni
authors.forename: Daniela
authors.initials: D
authors.lastname: Mantella
authors.forename: Andrea
authors.initials: A
authors.lastname: Pierantozzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Balducci
authors.forename: Stefano
authors.initials: S
authors.lastname: Condò
authors.forename: Salvatore
authors.initials: S
authors.lastname: DiGiulio
authors.forename: Lijljana
authors.initials: L
authors.lastname: Yancovic
authors.forename: Basilio
authors.initials: B
authors.lastname: Lippi
authors.forename: Simone
authors.initials: S
authors.lastname: Manca
authors.forename: Massimo
authors.initials: M
authors.lastname: Morosetti
authors.forename: Luigi
authors.initials: L
authors.lastname: Pellegrino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
authors.forename: Massimo Taccone
authors.initials: MT
authors.lastname: Gallucci
authors.forename: Giorgio
authors.initials: G
authors.lastname: Splendiani
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002114:Calcinosis / Q000453:epidemiology*; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000628:therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone