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Cardiovascular complications caused by advanced secondary hyperparathyroidism in chronic dialysis patients; special

Norihiko Goto1, Yoshihiro Tominaga, Susumu Matsuoka

  • 1Nagoya Daini Red Cross Hospital, 2-9 Myouken-cho, Showa-ku, Nagoya 466-8650, Japan. ngoto@nagoya2.jrc.or.jp

Clinical and Experimental Nephrology
|June 28, 2005
PubMed

Insights

Secondary hyperparathyroidism (2° HPT) can cause dilated cardiomyopathy (DCM). Parathyroidectomy (PTx) significantly improved left ventricular function in dialysis patients with DCM due to 2° HPT.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Dilated cardiomyopathy (DCM) secondary to hyperparathyroidism (2° HPT) is not well-characterized.
  • The impact of 2° HPT on cardiac function in dialysis patients requires further investigation.

Purpose of the Study:

  • To determine the morbidity of DCM caused by 2° HPT.
  • To evaluate the efficacy of parathyroidectomy (PTx) in improving cardiac function in dialysis patients with advanced 2° HPT.

Main Methods:

  • Prospective analysis of 237 dialysis patients undergoing PTx.
  • Cardiac assessment before and 6 months after PTx in 10 patients with DCM (4% of cohort).
  • Evaluation included echocardiography and clinical assessment of left ventricular (LV) function.

Main Results:

  • Significant improvement in LV ejection fraction (LVEF) from 31.0% to 56.8% (P = 0.0003) six months post-PTx.
  • Reduction in LV end-diastolic dimension (LVDd) from 59.8 mm to 46.3 mm (P = 0.0014).
  • Improvement in DCM symptoms and dialysis-related hypotension observed after PTx.

Conclusions:

  • Advanced 2° HPT negatively impacts LV function, leading to DCM.
  • PTx effectively reverses LV dysfunction in dialysis patients with DCM secondary to 2° HPT.
  • Prompt PTx is recommended for patients with DCM caused by 2° HPT.
Abstract

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