[Parathormone as a cardiovascular risk factor in uraemic patients on haemodialysis treatment]

Cardiovascular diseases represent the leading cause of mortality in patients with end-stage renal disease treated by hemodialysis. Left ventricular hypertrophy (LVH), which is connected with various risk factors present in this population of patients, represents a major factor of high mortality.

To determine the plasma levels of parathormone (PTH, levels of serum calcium (Ca) and phosphorus (P) in patients treated by hemodialysis, and investigate the impact of PTH as a possible risk factor for LV morphology changes.

The study included 50 patients with end-stage renal disease during the first two years of haemodialysis treatment. They were followed during the period of 12 months and had the same conditions of hemodialysis treatment. All participans have the echocardiography performed, as well as serial measurements of serum calcium and phosphorus by standard laboratory tests, and measurement of PTH by immunoradiometry.

More than 2/3 of selected patients (72%) showed signs of LVH at the beginning of the study. Patients with concentric LVH have significantly higher levels of PTH than those with normal echocardiography finding. Especially high levels of PTH were observed in patients with global sistolic-diastolic LV failure (more than 84,5% than the patients with normal echocardiography). PTH is significantly and independently associated with LV mass (p=0,002) and LV volume increment (p=0,040) noted by echocardiography. Ca x P product showed higher values in patient with sistolic-diastolic LV failure as compared to patients with normal LV echocardiography.

PTH appears to be an independent predictor of significant changes in LV mass and volume, which indicates that this "uremic toxine" has the importance of risk factor for uremic cardiomiopathy.