Clinical and Experimental Nephrology

, Volume 16, Issue 1, pp 130–135

Influence of renin–angiotensin system on serum parathyroid hormone levels in uremic patients

Authors

    • Division of Nephrology, Department of Internal MedicineShowa University Fujigaoka Hospital
  • Daisuke Komukai
    • Division of Nephrology, Department of Internal MedicineShowa University Fujigaoka Hospital
  • Makoto Hirose
    • Division of Nephrology, Department of Internal MedicineShowa University Fujigaoka Hospital
  • Ashio Yoshimura
    • Division of Nephrology, Department of Internal MedicineShowa University Fujigaoka Hospital
  • Ryoichi Ando
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
  • Toshifumi Sakaguchi
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
  • Yasuhiro Komatsu
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
  • Toshio Shinoda
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
  • Daijo Inaguma
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
  • Nobuhiko Joki
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
  • Hidemi Nishida
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
  • Masato Ikeda
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
  • Takashi Shigematsu
    • Study Group of Assessing Initiation of Renal Replacement Therapy (START)
Original Article

DOI: 10.1007/s10157-011-0534-x

Cite this article as:
Koiwa, F., Komukai, D., Hirose, M. et al. Clin Exp Nephrol (2012) 16: 130. doi:10.1007/s10157-011-0534-x

Abstract

Introduction

The aim of this study was to investigate the factors influencing serum parathyroid (PTH) levels, including medications for treating chronic kidney disease–mineral and bone metabolism disorder (CKD-MBD) in patients with end-stage renal disease.

Methods

We enrolled 1,076 patients in nine Japanese facilities who had begun hemodialysis (HD) due to ESRD. We investigated the relationships between intact PTH (iPTH) levels and clinical parameters and medications just prior to beginning HD.

Results

Significant decreases in serum iPTH levels were seen in males, in the presence of diabetes mellitus (DM), and with administration of renin–angiotensin system inhibitors (RASIs). Significant correlations were found between serum calcium and iPTH levels. In the patients administered RASIs, there was a significant decrease in serum iPTH levels with DM, male gender, and administration of active vitamin D sterols (VDs) compared with those not administered RASIs, although serum-corrected calcium levels were not different. Multiple regression analysis found gender, age, presence of DM, and serum calcium and phosphate levels to be significant contributing factors. In addition, administration of angiotensin II receptor blockers (ARBs) may also be a contributing factor to iPTH levels at the beginning HD (p = 0.050).

Conclusions

In this study, serum iPTH levels were related to administration of ARBs besides gender, age, the presence of DM and serum calcium levels. Our study suggests that the RA system involve serum iPTH levels in uremic patients.

Keywords

Active vitamin D sterolsGenderParathyroid hormoneRenin–angiotensin system inhibitorsSecondary hyperparathyroidism

Copyright information

© Japanese Society of Nephrology 2011