Pathological analysis of effect of secondary hyperparathyroidism on arteriovenous fistula in maintenance hemodialysis patients
10.3760/cma.j.issn.1008-6706.2015.14.007
- VernacularTitle:维持性血液透析患者继发性甲状旁腺功能亢进对自体动静脉内瘘影响病理学分析
- Author:
Tao LIU
;
Gen LI
;
Jinlian LU
- Publication Type:Journal Article
- Keywords:
Hemodiafiltration;
Hyperparathyroidism,Secondary;
Arteriovenous Fistula;
Pathology
- From:
Chinese Journal of Primary Medicine and Pharmacy
2015;(14):2101-2103
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of maintenance hemodialysis(MHD)patients with secondary hyperparathyroidism on radial artery calcification and arteriovenous fistula( AVF) function.Methods The specimens of radial artery and cephalic vein were collected from the 35 cases of MHD patients at the first time of arteriovenous fistula operation.The specimens were collected again when AVF loss function more than 2 years.Specimens of the arteries were examined histologically for calcification with von Kossa staining.According to the parathyroid hormone levels,the patients were divided into three groups,as mild secondary hyperparathyroidism group (iPTH<300pg/L) of 16 cases,moderate secondary hyperparathyroidism group (iPTH≥300pg/L,<800pg/L) of 7 cases,severe secondary hyperparathyroidism group ( iPTH≥800pg/L) of 12 cases.The pathological results were analyzed.Results The pathological results showed radial artery calcification and calcium salt staining positive significantly increased in the 35 cases of MHD patients[9cases(25.7%)vs 2cases(8.6%)],compared with the first time of arteriovenous fistula operation when AVF loss function (χ2 =5.290,P=0.020).The artery calcification was also located in the layer of medial smooth muscle cells.The radial artery specimens with calcium salt staining positive increased significantly in severe hyperparathyroidism patients group[12cases(25.7%) vs 1case(6.3%)],compared with mild secondary hyperparathyroidism patients(χ2 =5.168,P =0.012).Conclusion Calcification risk of radial artery in AVF is increased in MHD patients with secondary hyperparathyroidism.And hyperparathyroidism may be one cause of AVF failure.
