Abstract: Objective To analyze the characteristics of cardiac structure and function and the related factors in patients with refractory secondary hyperparathyroidism (SHPT). Methods A total of 82 end-stage renal disease cases with refractory SHPT and treated with parathyroidectomy (PTX) were retrospectively studied. There were 44 males and 38 females with average age of 46.7±14.1 years old and average dialysis duration of 128.5±49.6 months (36～216 months). Thirty maintenance hemodialysis (MHD) patients treated at the same period were used as the control group. Serum creatinine (Scr), albumin (Alb), calcium (Ca2+), phosphorus (P), alkaline phosphatase (ALP), hemoglobin (Hb) and intact parathyroid hormone (iPTH) were assayed before hemodialysis. LVDd, IVS, PWTH, EF and E/A were measured by echocardiography. LVMI was calculated by a formula, and the relationship between LVMI and clinical indices was then analyzed. Results Compared with the control group, the PTX group had significantly higher rates of left ventricular hypertrophy (96.3% vs. 63.33%), left ventricular systolic dysfunction (79.27% vs. 43.33%), left ventricular diastolic dysfunction (75.6% vs. 26.6%), and valve calcification (P<0.05 or <0.01). Multivariate linear regression analysis showed a positive correlation between LVMI and the values of dialysis duration, serum P and iPTH (r=0.47, 0.76, and 0.68, respectively; P<0.05). Conclusion End-stage renal disease patients with refractory SHPT had higher incidences and severer degrees of left ventricular hypertrophy and left ventricular dysfunction than other MHD patients. PTX should be considered for patients with refractory SHPT to reduce their cardiovascular mortality.

Key words: Maintenance hemodialysis, Refractory secondary hyperparathyroidism, Cardiac structure and function