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The Effects of Secondary Hyperparathyroidism on Circadian Blood Pressure in Hemodialysis Patients.

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OBJECTIVE To determine the relationship between secondary hyperparathyroidism (sHPT) and circadian blood pressure (BP) rthym among patients undergoing hemodialysis treatment. STUDY DESIGN A descriptive and prospective cohort study. PLACE AND… Click to show full abstract

OBJECTIVE To determine the relationship between secondary hyperparathyroidism (sHPT) and circadian blood pressure (BP) rthym among patients undergoing hemodialysis treatment. STUDY DESIGN A descriptive and prospective cohort study. PLACE AND DURATION OF STUDY   Department of Nephrology, Firat University Hospital, Turkey, between June and December 2019. METHODOLOGY Eighty-five patients, undergoing hemodialysis three times a week, were included. The BP parameters and circadian blood pressure rhythm were measured by the mobil-o-graph sphygmomanometer. Non-dipper blood pressure phenomenon was defined as a night-time mean artery pressure (MAP)  decrease of <10% from the daytime MAP; sHPT was defined as parathormone >300 pg/ml. RESULTS Of the 85 participants, mean age was 57.07 ± 14.46 years. In cohort, sHPT rate 58.8% (n =50) and non-dipper blood pressure pattern rate was 64.7% (n = 55). Systolic blood pressure (p=0.001), diastolic blood pressure (p=0.001), and mean arterial blood pressure (p<0.001) were higher in participants with sHPT. sHPT (p = 0.003) was an independent risk factor for non-dipper blood pressure pattern (odds ratio [OR] 0.065, 95% CI: 0.11-0.390). A negative correlation was identified between parathormone and the reduction in night blood pressure (r = -0.346, p=0.001). CONCLUSION Secondary hyperparathyroidism can cause non-dipper blood pressure pattern by reducing the reduction in night blood pressure. Treatment of sHPT is important in the control of blood pressure and normal circadian blood pressure rhythm in tertiary protection in hemodialysis patients. Key Words: Blood pressure, Circadian rhythm, Hyperparathyroidism secondary, Hemodialysis, Chronic kidney diseases.

Keywords: hemodialysis; hyperparathyroidism; blood pressure; circadian blood; pressure

Journal Title: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
Year Published: 2021

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