Is parathormone a cardiac toxin in uremia?

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Updated: Sep 27, 2026

Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation
07:13

Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation

Published on: March 14, 2017

R B Himelman1, C A Helms, N B Schiller

  • 1John Henry Mills Echocardiography Laboratory, University of California, San Francisco.

International Journal of Cardiac Imaging
|January 1, 1988
PubMed

Insights

Parathyroid hormone (PTH) in uremia is linked to hypertension but not directly to left ventricular hypertrophy or mitral annular calcification (MAC). Renal transplantation improves cardiac structure but does not resolve MAC.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Uremia is associated with elevated parathyroid hormone (PTH), which may contribute to cardiovascular complications.
  • Left ventricular hypertrophy (LVH), cardiomyopathy, and mitral annular calcification (MAC) are common in patients with chronic kidney disease.
  • The relationship between PTH, cardiac structure, and MAC in uremic patients undergoing renal transplantation requires further investigation.

Purpose of the Study:

  • To investigate the association between serum PTH levels, electrolytes, and cardiovascular parameters in uremic patients before and after renal transplantation.
  • To assess the impact of renal transplantation on left ventricular mass, wall thickness, ejection fraction, and MAC.
  • To determine if PTH levels correlate with cardiac abnormalities or MAC in end-stage renal disease.

Main Methods:

  • Echocardiography was used to measure left ventricular wall thickness, mass index, and ejection fraction.
  • Mitral annular calcification (MAC) presence and extent were assessed by echocardiography.
  • Serum levels of PTH, calcium, phosphate, and magnesium were measured before and after renal transplantation in 44 patients.

Main Results:

  • Pre-transplant, 41% of patients had MAC. Elevated PTH (>1000 mcl eq/ml) was associated with higher pre-transplant systolic blood pressure.
  • Post-transplant, significant reductions in left ventricular mass index and diastolic wall thickness were observed (p<0.05).
  • No significant correlation was found between PTH or electrolyte levels and cardiac parameters or MAC, either pre- or post-transplant. MAC did not resolve after transplantation.

Conclusions:

  • While PTH does not directly correlate with LVH, cardiac function, or MAC in uremia, elevated pre-transplant levels are linked to hypertension.
  • Renal transplantation improves cardiac structural parameters but does not reverse established MAC.
  • PTH may act as a mild pressor agent in some patients with end-stage renal failure.

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