Changes in cardiovascular calcification after parathyroidectomy in patients with ESRD.

Bleyer AJ, Burkart J, Piazza M, Russell G, Rohr M, Carr JJ
Am J Kidney Dis. 2005 46 (3): 464-9

PMID: 16129208 · DOI:10.1053/j.ajkd.2005.04.035

BACKGROUND - The effect of parathyroidectomy on vascular calcification in patients with end-stage renal disease has been a subject of interest for many years, although studies in this area have not been definitive. The purpose of this investigation is to determine changes in vascular calcification after subtotal parathyroidectomy by using fast-gated helical computed axial tomographic imaging to measure coronary and carotid artery calcification.

METHODS - Computed tomographic imaging was performed at baseline and in follow-up on 10 patients who had undergone subtotal parathyroidectomy and 10 reference patients who had not undergone parathyroidectomy.

RESULTS - Patients who underwent subtotal parathyroidectomy had a mean change in coronary calcification of -92.3 +/- 469/y, and reference patients had a mean change of +479 +/- 630/y (P = 0.03). The 2 parathyroidectomy patients with the highest baseline scores had significant declines in both coronary and carotid calcification.

CONCLUSION - In this study, subtotal parathyroidectomy is associated with a significant decrease in vascular calcification in 2 of 10 dialysis patients with high coronary artery calcium scores and stabilization in 7 of 10 patients with low baseline scores.

MeSH Terms (16)

Adult Calcinosis Carotid Artery Diseases Coronary Angiography Coronary Disease Cross-Sectional Studies Female Humans Hyperparathyroidism, Secondary Kidney Failure, Chronic Male Middle Aged Parathyroidectomy Renal Dialysis Tomography, Spiral Computed Treatment Outcome

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