ORIGINAL PAPER
Pulmonary artery pressure in association with serum parathormone in maintenance hemodialysis patients

Introduction: There are several potential explanations for the development of PH in patients with stable hemodialysis patients. Hormonal and metabolic derangement associated with end-stage renal failure might lead to pulmonary arterial vasoconstriction and an increase of the pulmonary vascular resistance. The aim of this study was to consider the association of pulmonary artery pressure (PAP) with serum parathormone in end-stage renal disease (ESRD) patients under regular hemodialysis treatment. Material and methods: This cross-sectional study was conducted on patients with end-stage renal disease undergoing maintenance hemodialysis treatment through an arteriovenous fistula which was created on the hand, and with acetate basis dialysate and polysulfone membranes. For all patients serum intact parathormone (iPTH) was measured. For assessment of pulmonary artery pressure, all patients were subjected to two-dimensional and doppler echocardiographic studies that were done for the patients after their hemodialysis sessions. Results: The study comprised 102 patients (F=46, M=56) consisting of 73 non diabetic hemodialysis patients (F=33, M=40), and 29 diabetic hemodialysis patients (F=13, M=16). The duration of hemodialysis was 17.8±29 months. The mean ±SD of serum iPTH of total patients was 338±306 pg/ml. The mean ±SD of pulmonary artery systolic pressure (PAP) was 41.5±12.6 mmHg. A significant positive correlation of PAP with the dosage (r=0.36, p=0.001) and duration of hemodialysis (r=0.35, p<0.001) was seen, also a significant positive correlation of pulmonary artery systolic pressure with serum intact parathormone (iPTH) in hemodialysis patients was found. Conclusions: A significant positive correlation of serum intact parathormone with pulmonary artery pressure, which is a new aspect of uncontrolled secondary hyperparathyroidism implies the need for a better control of poorly controlled hyperparathyroidism disease in hemodialysis patients.