Effect of hyperparathyroidism on vascular stiffness in hemodialysis patients

Abstract

Abstract Background Cardiovascular disease (CVD) is present in > 50% of patients undergoing dialysis and the relative risk of death due to CVD events in HD patients is reported to be 20 times higher than in the general population. In fact, in patients on renal replacement therapy (RRT) the prevalence of coronary heart disease and ventricular hypertrophy has been described to be 40% and 70% respectively, other CVD events include hypertention, arrhythmias, valvular calcification and arterial stiffness. Objective To detect the prevalence of arterial stiffness among end stage renal disease patients on prevalent hemodialysis with hyperparathyroidism. Patients and Methods This observational cross sectional study was conducted on 60 prevalent hemodialysis patients attending at hemodialysis unit of Ain Shams University hospitals, with convenient sampling method. The included patients are clinically stable on thrice weekly hemodialysis sessions for 4 hours per session. Results The Dual Pulse Wave Doppler (DPWD) method we proposed in this study may be considered as a useful and convenient option for clinical local Pulse Wave Velocity (PWV) measurement, this clinical practical and reproducible method had the capability to detect an increased local PWV of LCCA (which reflect arterial stiffness) in the patients with PTH > 300 more than the patients with PTH < 300 as it showed that in Group B (PTH>300), the measured carotid artery local PWV values ranged from 6.22 m/s to 8.84 m/s and the mean value was 7.81 ± 0.72 m/s, which was higher than 6.72 ± 1.06 m/s (ranging from 4.48 m/s to 8.44 m/s) of Group A (PTH<300). Conclusion Our study showed that there is a high prevalence of arterial stiffness in prevalent hemodialysis patients.