Effect of Intravenous Active Vitamin-D Treatment on the Left Ventricular Mass Index in Chronic Hemodialysis Patients with Secondary Hyperparathyroidism

Abstract

Objective: We investigated the effect of active D vitamin therapy on echocardiographic examination results in hemodialysis patients with hyperparathyroidism. Materials and Methods: This prospective study involved 20 patients who undergoing HD for a total of 12 hours per week at least 6 months. Patients with serum intact parathormone level (iPTH) >= 20.8 pmol/L, phosphorus level 3.5 - 5.5 mg/dL, calcium level <9.5 mg/dL included in this study. Before and after 6 months active vitamin D treatment, left ventricular mass index (LVMI) of all patients were investigated by echocardiography. Results: The mean age was 51.2 +/- 15.0 Ten patients were female and ten patients were male. The mean iPTH level in serum before and six months after active vitamin-D treatment were 35.97 +/- 16.41 and 24.92 +/- 13.28 pmol/L respectively (p<0.001). Before and six months after active vitamin-D treatment the mean LVMI were 294.40 +/- 103.2 gr/m(2) and 250.40 +/- 101.44 gr/m(2) respectively. LVMI was statistically significant decreased after six months treatment compared to before treatment (p<0.001). Conclusion: Increased serum iPTH levels in patients undergoing HD decrease with active vitamin-D treatment and this results in significant reduction in LVMI. Our results show that treatment of hyperparathyroidism plays an important role in correcting LVH.