title: Parathyroidectomy and heart rate variability in patients with stage 5 CKD.
abstract: OBJECTIVE
  Lower heart rate variability implies increased risk of cardiovascular disease. This study aimed to evaluate the relationship between mineral metabolism and heart rate variability and longitudinal changes of heart rate variability after parathyroidectomy in stage 5 CKD patients.
  
  
  METHODS
  This cross-sectional study included 118 stage 5 CKD patients, 87 controls, and a prospective study in two subgroups classified as successful (n=17) and unsuccessful (n=4) parathyroidectomy follow-up enrolled from March of 2011 to December of 2012. Blood examination and 24-hour Holter for heart rate variability were measured.
  
  
  RESULTS
  Most heart rate variability indices were lower in stage 5 CKD patients. In multivariate stepwise regression models, serum intact parathyroid hormone was correlated with mean normal-to-normal R-R intervals, mean heart rate, and very low frequency, serum calcium was correlated with SD of 5-minute average of normal R-R intervals, and serum phosphorus was correlated with very low frequency and low frequency/high frequency. Compared with baseline, the successful parathyroidectomy subgroup had significant improvements in mean normal-to-normal R-R intervals, mean heart rate, SD of normal-to-normal R-R intervals, SD of 5-minute average of normal R-R intervals, very low frequency, high frequency, and low frequency/high frequency. There was no significant change of heart rate variability in patients after unsuccessful parathyroidectomy.
  
  
  CONCLUSIONS
  Disorders of mineral metabolism are associated with decreased heart rate variability in stage 5 CKD. Successful parathyroidectomy may contribute to reverse this cardiovascular disease risk in severe secondary hyperparathyroidism patients.
authors: Department of Nephrology, First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
authors: Jing
authors: J
authors: Zhang
authors: Xiangbao
authors: X
authors: Yu
authors: Bin
authors: B
authors: Sun
authors: Jianling
authors: J
authors: Bai
authors: Yongyue
authors: Y
authors: Wei
authors: Xiaoming
authors: X
authors: Zha
authors: Yiyao
authors: Y
authors: Cui
authors: Ming
authors: M
authors: Zeng
authors: Jingjing
authors: J
authors: Zhang
authors: Jia
authors: J
authors: Liu
authors: Huijuan
authors: H
authors: Mao
authors: Bo
authors: B
authors: Zhang
authors: Haibin
authors: H
authors: Ren
authors: Yifei
authors: Y
authors: Ge
authors: Xueqiang
authors: X
authors: Xu
authors: Zhixiang
authors: Z
authors: Shen
authors: Changying
authors: C
authors: Xing
authors: Kejiang
authors: K
authors: Cao
authors: Ningning
authors: N
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology / Q000601:surgery*
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