SHPT May Predict Left Ventricular Diastolic Dysfunction
iPTH significantly correlated with measures of diastolic dysfunction in patients with non-dialysis chronic kidney disease.
A new study correlates higher levels of intact parathyroid hormone (iPTH) with indicators of left ventricular diastolic dysfunction in patients with pre-dialysis chronic kidney disease (CKD).
Il Young Kim, MD, and colleagues from Pusan National University Yangsan Hospital in South Korea, examined imaging results from 332 CKD patients with estimated glomerular filtration rates (eGFR) below 60 mL/min/1.73m2 and not on dialysis. Of these, 198, 84, and 50 patients had CKD stage 3, 4, and 5, respectively.
Diastolic dysfunction severity increased along with CKD stage: Patients displayed lower peak early mitral annular velocity (E') and higher ratios of early mitral inflow velocity (E) to E', according to tissue Doppler imaging results. The team found no significant differences between groups in left ventricular ejection fraction, which was assessed via 2-D echocardiography, however.
Both univariate and multivariate analysis showed that iPTH significantly correlated with E' and E/E' after adjustment. iPTH did not correlate with systolic dysfunction.
These findings suggest that SHPT is an independent predictor of left ventricular diastolic dysfunction, Dr Kim and his colleagues concluded. They advised future studies to determine whether treating SHPT prevents left ventricular diastolic dysfunction.
Kim IY, Kwak IS, Park IS, et al. Secondary hyperparathyroidism is independently associated with left ventricular diastolic dysfunction in patients with CKD. Data were presented as a Kidney Week 2017 publication-only abstract: PUB567.