Effects of parathyroidectomy on blood bone markers and heart rate variability in patients with stage 5 chronic kidney disease

Chen, Huimin; Cao, Ying; Xing, Changying; Purrunsing, Yogendranath; Zha, Xiaoming; Shen, Chong; Zhang, Ming; Yang, Guang; Yu, Xiangbao; Zhang, Lína; Jiang, Yao; Shen, Zhi-Xiang; Ma, Haoyang; Chen, Yin; Li, Yunfei; Wang, Ningning

doi:10.1007/s11255-018-1995-6

Cited by 3 publications

(2 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PTH not only affects the structure and function of the heart, but also is related to the disorder of the HRV indices and the autonomic nerve function in CKD patients. An increase in the blood iPTH levels may aggravate the damage to the autonomic nervous system [ 11 , 37 , 38 ]. The aim of this study was to observe the relationships between iPTH, (1-84) PTH, (7-84) PTH, and the HRV indices in CKD5 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Successful PTX can reverse the disorders of bone mineral metabolism and HRV indices and reduce cardiovascular and all-cause mortality in CKD5 patients [ 6 , 12 ]. We have demonstrated that in PTX patients, improved HRV indices were correlated with decreased blood levels of bone biomarkers [iPTH, bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5 b (TRACP-5b), fibroblast growth factor 23 (FGF23)] [ 38 ]. In this study, patients with PTX were followed up over three months after the surgery (median follow-up time: 6.50 months).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of parathyroidectomy on plasma PTH fragments and heart rate variability in stage 5 chronic kidney disease patients

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction Circulating intact parathyroid hormone (iPTH) levels include full-length (1-84) PTH and long C-PTH fragments, but primarily (7-84) PTH, which have been reported to have antagonistic effects on the bones and kidneys. However, their effects on the cardiovascular system remain unclear. In this study, the relationships between the plasma PTH fragments levels and heart rate variability (HRV) in stage 5 chronic kidney disease (CKD5) patients are explored. Furthermore, the effects of parathyroidectomy (PTX) on the above indices are investigated. Methods In this cross-sectional study, 164 healthy controls and 354 CKD5 patients, including 208 secondary hyperparathyroidism (SHPT) subgroup with PTX, were enrolled. Circulating (7-84) PTH levels were calculated by subtracting plasma (1-84) PTH levels from iPTH levels. The HRV parameters were measured using a 24-hour Holter. Results The baseline levels of plasma iPTH, (1-84) PTH, and (7-84) PTH in the CKD5 patients were 930.40 (160.65, 1792.50) pg/mL, 448.60 (99.62, 850.45) pg/mL, and 468.20 (54.22, 922.55) pg/mL, respectively. In the CKD5 patients, plasma (1-84) PTH levels were independently correlated with the standard deviation of the normal-to-normal R-R intervals (SDNN) and the standard deviation of the five-minute average of the normal R-R intervals (SDANN). With a median follow up time of 6.50 months after PTX in the SHPT patients ( n = 30), improved SDNN and SDANN markers were related with decreased (1-84) PTH levels. Furthermore, an improved SDNN was related with decreased (7-84) PTH levels. Conclusions The CKD5 patients’ baseline (1-84) PTH levels were correlated with the SDNN and SDANN. After PTX, an improved SDNN was related with decreased (1-84) PTH and (7-84) PTH levels, while improved SDANN was related with decreased (1-84) PTH levels. No antagonistic effects of (1-84) PTH and (7-84) PTH on HRV were found in the CKD5 patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of parathyroidectomy on plasma PTH fragments and heart rate variability in stage 5 chronic kidney disease patients

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

Parathyroidectomy Is Associated With Reversed Nondipping Heart Rate That Impacts Mortality in Chronic Kidney Disease Patients

et al. 2022

View full text Add to dashboard Cite

Cardiovascular autonomic nervous system dysfunction in chronic kidney disease and end-stage kidney disease: disruption of the complementary forces

Soomro

Charytan

2020

Current Opinion in Nephrology &Amp; Hypertension

View full text Add to dashboard Cite

Purpose of review Several nontraditional risk factors have been the focus of research in an attempt to understand the disproportionately high cardiovascular morbidity and mortality in chronic kidney disease (CKD) and end-stage kidney disease (ESKD) populations. One such category of risk factors is cardiovascular autonomic dysfunction. Its true prevalence in the CKD/ESKD population is unknown but existing evidence suggests it is common. Due to lack of standardized diagnostic and treatment options, this condition remains undiagnosed and untreated in many patients. In this review, we discuss current evidence pointing toward the role of autonomic nervous system (ANS) dysfunction in CKD, building off of crucial historical evidence and thereby highlighting the areas in need for future research interest. Recent findings There are several key mediators and pathways leading to cardiovascular autonomic dysfunction in CKD and ESKD. We review studies exploring the mechanisms involved and discuss the current measurement tools and indices to evaluate the ANS and their pitfalls. There is a strong line of evidence establishing the temporal sequence of worsening autonomic function and kidney function and vice versa. Evidence linking ANS dysfunction and arrhythmia, sudden cardiac death, intradialytic hypotension, heart failure and hypertension are discussed. Summary There is a need for early recognition and referral of CKD and ESKD patients suspected of cardiovascular ANS dysfunction to prevent the downstream effects described in this review. There are many unknowns in this area and a clear need for further research.

show abstract

Effects of parathyroidectomy on blood bone markers and heart rate variability in patients with stage 5 chronic kidney disease

Cited by 3 publications

References 33 publications

Effects of parathyroidectomy on plasma PTH fragments and heart rate variability in stage 5 chronic kidney disease patients

Effects of parathyroidectomy on plasma PTH fragments and heart rate variability in stage 5 chronic kidney disease patients

Parathyroidectomy Is Associated With Reversed Nondipping Heart Rate That Impacts Mortality in Chronic Kidney Disease Patients

Cardiovascular autonomic nervous system dysfunction in chronic kidney disease and end-stage kidney disease: disruption of the complementary forces

Contact Info

Product

Resources

About