Low iPTH can predict vascular and coronary calcifications in patients undergoing peritoneal dialysis.
BACKGROUND
There is substantial evidence that low levels of serum intact parathyroid hormone (iPTH) are associated with vascular calcium deposition and subsequent increased cardiovascular risk in chronic kidney disease patients. The purpose of this study was to determine the relationship between the serum iPTH level, and vascular and coronary artery calcifications (VCs, CACs) and arterial stiffness in peritoneal dialysis (PD) patients.


METHODS
In this cross-sectional study, 93 PD patients were included. VCs, CACs and arterial stiffness were measured by simple X-rays of the hands and pelvis, multi-slice coronary CT and brachial-ankle pulse wave velocity (BaPWV).


RESULTS
Patients were divided into 3 groups according to iPTH levels. The prevalence of severe VCs (VC score ≥ 3) was highest in the low iPTH group (<150 pg/ml). In multivariate analysis, the presence of diabetes mellitus and a low iPTH were shown to be significant risk factors for severe VCs. In addition, a simple VC score of ≥ 1 was a significant variable for predicting severe CACs (CAC score ≥ 400).


CONCLUSIONS
Low iPTH and the presence of diabetes mellitus are thought to be independent risk factors for predicting VCs. VCs determined by simple X-ray can further predict the coexistence of CACs that ultimately might contribute to increased cardiovascular risk in PD patients.
Kim
Sun Chul
SC
Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, College of Medicine, Seoul, Korea.
Kim
Hye Won
HW
Oh
Se Won
SW
Yang
Ha Na
HN
Kim
Myung-Gyu
MG
Jo
Sang-Kyung
SK
Cho
Won Yong
WY
Kim
Hyoung Kyu
HK
D002114:Calcinosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D010530:Peritoneal Dialysis / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity
D010281:Parathyroid Hormone