January - March 2010, Volume 6, Issue 1

Moldovan D, Rusu C, Patiu I, Racasan S, Orasan R, Kacso I, Brumboiu I, Bondor C, Gherman-Caprioara M

Could the serum parathormone be a predictive marker for peripheral vascular calcifications in chronic dialysis patients? Experience of a single center in Transylvania

Acta Endo (Buc) 2010, 6 (1): 43-55
doi: 10.4183/aeb.2010.43

Background. Vascular calcifications (VCs) represent an important complication in dialysis patients. It is still a subject of debate whether VCs are associated with low or high intact parathormone (iPTH), or if it is not any relation.\r\nThe purpose of this study was to assess the predictive value of iPTH and other mineral markers for VCs development.\r\nMethods. The study evaluated peripheral VCs in haemodialysis (HD) and peritoneal dialysis (PD) patients using radiographies. We counted a semiquantitative score ranging from 0 to 8. Each category was divided into two groups according to VCs score. We assessed the relationship between the VCs score and mineral markers.\r\nResults. A VC score=2 was positively associated with male gender, serum Ca, P, CaxP, ALP and iPTH levels in HD patients. There was no correlation with age, HD vintage, received treatment. In PD patients, did CaxP have a higher significance with VC score>/2; were iPTH, CaxP and P of higher significance for a score=5.\r\nConclusions. Hyperparathyroidism can be considered a predictor for VCs development in dialysis patients. Other risk factors are increased serum Ca, P, CaxP and ALP levels. In PD patients, high iPTH could predict VCs only for severe calcifications, but the CaxP could even predict for less extended VCs.

Keywords: peripheral vascular calcifications, dialysis, mineral metabolism markers

Correspondence: M. Gherman-Caprioara MD; PhD. “Mihai Manasia” Nephrology\r\nClinic. 3-5, Clinics str. 400006 Cluj-Napoca, Romania. E-mail: mmgherman@yahoo.com