Effects of parathyroidectomy on heart rate circadian rhythm in patients with stage 5 chronic kidney disease combined with severe secondary hyperparathyroidism
10.3760/cma.j.cn441217-20200709-00061
- VernacularTitle:甲状旁腺切除术对慢性肾脏病5期伴严重继发性甲状旁腺功能亢进患者心率昼夜节律的影响
- Author:
Ying CUI
;
Hui HUANG
;
Wenkai REN
;
Guang YANG
;
Ming ZENG
;
Xiaoming ZHA
;
Shaowen TANG
;
Yaoyu HUANG
;
Zhanhui GAO
;
Fangyan XU
;
Wenbin ZHOU
;
Hanyang QIAN
;
Jing WANG
;
Chun OUYANG
;
Xueyan GAO
;
Changying XING
;
Yongyue WEI
;
Ningning WANG
- From:
Chinese Journal of Nephrology
2021;37(5):414-423
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe heart rate circadian rhythm in patients with chronic kidney disease (CKD) stage 5 and to analyze the effects of parathyroidectomy (PTX) on heart rate circadian rhythm in severe secondary hyperparathyroidism (SHPT) patients.Methods:A cross-sectional observation was performed in 213 patients with CKD stage 5 and 96 controls, and the patients were divided into those with severe SHPT (PTX group, n=70) and without severe SHPT (non-PTX group, n=143). Forty-six PTX patients were followed up prospectively. The baseline data were compared among these groups. Holter electrocardiogram was performed for each participant. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Multiple linear regression analysis was used to analyze the related factors of heart rate circadian rhythm in patients with CKD stage 5. Results:The 24-hour, daytime and nighttime mean heart rate in patients with CKD stage 5 were all higher than those in controls, especially in PTX group (all P<0.05). The night/day heart rate ratios of controls and CKD stage 5 patients were (0.81±0.08) and (0.91±0.08) respectively ( P<0.01). Correlation analysis showed 24-hour and daytime or nighttime mean heart rate in patients with CKD stage 5 were positively correlated with serum levels of phosphorus and ln(alkaline phosphatase), while nighttime mean heart rate and night/day heart rate ratio were positively related with serum intact parathyroid hormone level. After adjusting with postoperative follow-up period (median time: 10.9 months), 24-hour and nighttime mean heart rate, and night/day heart rate ratio in PTX patients all decreased significantly (all P<0.01). Conclusions:Heart rate is increased and circadian rhythm is abnormal in patients with CKD stage 5, which are related with mineral and bone disorder. PTX significantly decreases 24-hour and nighttime mean heart rate in severe SHPT patients, and improves the heart rate circadian rhythm.
