Abstract: SA-PO906

Effects of Parathyroidectomy on Blood Bone Markers and Heart Rate Variability in CKD Patients

Session Information

  • Mineral Disease: CKD-Bone
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Mineral Disease

  • 1203 Mineral Disease: CKD-Bone

Authors

  • Wang, Ningning, Department of Nephrology,The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
  • Chen, Huimin, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
  • Zha, Xiaoming, First Affliated Hospital with Nanjing Medical University, Nanjing, China
  • Xing, Chang Ying, First Affiliated Hospital of Nanjing Medical University, Nanjing, JIangSu, China
Background

Lower heart rate variability (HRV) in chronic kidney disease (CKD) patients is associated with increased risk of cardiovascular disease (CVD). We aimed to evaluate the relationships between blood bone markers and HRV in stage 5 CKD patients, longitudinal changes in severe secondary hyperparathyroidism (SHPT) subgroup with parathyroidectomy (PTX) were also explored.

Methods

This cross-sectional study included 134 CKD patients, 100 controls, and a prospective study in PTX group(n=45) with median follow-up time of 6.7 months. Bone parameters included (1) intact parathyroid hormone (iPTH), as classic bone remodeling regulators; (2) bone-specific alkaline phosphatase (BAP), representing bone formation; (3) tartrate-resistant acid phosphatase (TRACP-5b), indicating bone resorption; (4) bone-derived hormone, fibroblast growth factor 23 (FGF23). HRV were measured by 24h Holter.

Results

Circulating bone markers of the participants were shown in Table 1. Baseline iPTH, BAP and lnFGF23 levels were independently associated with decreased HRV in CKD patients. Elevated blood iPTH, BAP, TRACP-5b, FGF23 levels and attenuated HRV were ameliorated after PTX, furthermore, improved HRV were associated with reduced iPTH, TRACP-5b and FGF23 levels(Fig1).

Conclusion

In CKD patients, circulating iPTH and FGF23 levels may play important roles in imbalances of cardiovascular autonomic nervous system while the roles of bone resorption/formation need more research.

Circulating Bone Markers of Different Participants
VariableControls
(n=100)
Stage 5 CKD Patients
(n=134)
Stage 5 CKD patients(n=134)
Non-PTX(n=89) PTX(n=45)
iPTH(pg/mL)35.6(27.4-49.0)495.7(193.5-1466.0)*252.0(108.1-495.7)1776.7(1147.2-2796.7)**
BAP(μg/L)16.3(13.2-19.6)22.1(13.7-76.0)*16.1(12.5-24.2)131.0(51.3-327.7)**
TRACP-5b(U/L)2.0(1.4-2.5)5.8(3.7-9.9)*4.8(3.0-7.8)10.5(6.1-17.9)**
FGF23(RU/mL)62.7(51.2-78.4)6390.9(1041.7-39476.2)*1477.6(682.4-6848.7)52636.1(17316.4-121101.2)**
LnFGF234.1±0.38.8±2.1*7.8±1.610.9±1.2**

*,compared with controls, P<0.001;**, compared with CKD with Non-PTX,P<0.001

Improved HRV were associated with reduced blood bone markers in PTX group

Funding

  • Government Support - Non-U.S.