Relationship between parathyroid hormone and renin–angiotensin–aldosterone system in hemodialysis patients with secondary hyperparathyroidism

• Published in: Journal of bone and mineral metabolism Vol. 39; no. 2; pp. 230 - 236
• Main Authors: Kono, Keiji, Fujii, Hideki, Watanabe, Kentaro, Goto, Shunsuke, Nishi, Shinichi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.03.2021; Springer Nature B.V
• Subjects: Aldosterone; Angiotensin; Blood Pressure; Body Fluids - metabolism; Calcium - blood; Calcium phosphates; Cardiovascular diseases; Chronic Kidney Disease-Mineral and Bone Disorder - blood; Female; Hemodialysis; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary - blood; Hyperparathyroidism, Secondary - surgery; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Original Article; Orthopedics; Parathyroid; Parathyroid hormone; Parathyroid Hormone - blood; Parathyroidectomy; Potassium - blood; Renal Dialysis; Renin; Renin-Angiotensin System; Sodium; Renin–angiotensin–aldosterone system; Parathyroid hormone; Hemodialysis
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-020-01139-5

Introduction Hyperparathyroidism (HPT) is associated with mortality and cardiovascular disease (CVD) in dialysis patients. However, its mechanism is still unclear. It is suspected that parathyroid hormone (PTH) is associated with the renin–angiotensin–aldosterone system (RAAS) as a possible mechanism. Thus, we examined their hormonal interaction in hemodialysis patients with secondary HPT. Materials and methods Seventeen hemodialysis patients with HPT were included. All patients underwent total parathyroidectomy (PTx). Serum intact PTH (iPTH), calcium and phosphate levels, plasma renin activity (PRA), and plasma aldosterone levels (ALD) were measured pre- and post-PTx. Results Pre-serum iPTH tended to be correlated with pre-PRA and were significantly correlated with pre-ALD (pre-PRA: r  = 0.44, p  = 0.07, pre-ALD: r  = 0.49, p  < 0.05). With the reduction in serum iPTH after PTx, PRA and ALD significantly decreased after PTx. Additionally, the change in serum iPTH tended to be correlated with the changes in PRA and ALD (PRA; r  = 0.46, p  = 0.05, ALD; r  = 0.45, p  = 0.06). Conclusion Our results suggest that PTH could be interrelated with RAAS in hemodialysis patients with secondary HPT.