Τομέας Παθολογίας
Library of the School of Health Sciences

2018-11-14

2018

Giakoumis Michail

Δημήτριος Τούσουλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Τσιούφης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Εμμανουήλ Βαβουρανάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ελευθέριος Τσιάμης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Σιάσος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνα Αγγελή, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ευστάθιος Μανιός, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Η επίδραση της θεραπείας με παρικαλσιτόλη στην αρτηριακή σκληρότητα και τα επίπεδα ADMΑ, οστεοπροτεγερίνης και οστεοποντίνης ορού σε υπερτασικούς ασθενείς με χρόνια νεφρική νόσο σταδίου 3-5 και δευτεροπαθή υπερπαραθυρεοειδισμό

Greek

Effects of oral paricalcitol therapy on arterial stiffness and serum levels of ADMA, osteoprotogerin and osteopontin in hypertensive patients with chronic kidney disease and secondary hyperparathyroidism

Arterial stiffness is linked to the progression of atherosclerosis, while activation of vitamin D receptor exerts favorable cardiovascular effects in patients with renal insufficiency.
Purpose: In this study, we investigated the effects of oral treatment with paricalcitol,
a potent vitamin D receptor activator on arterial stiffness and osteopontin, a marker of
atherosclerosis, in hypertensive patients with chronic kidney disease (CKD) and
secondary hyperparathyroidism.
Material and methods: We followed up 29 treated hypertensive patients (mean age
74.1 years, 19 men, office blood pressure=132/85mmHg) with CKD stages 3-5 [mean
glomerular filtration rate (GFR)=19.4 ml/min/1.73m2], who were on therapy with oral
paricalcitol for 1 year. All patients at baseline underwent a complete physical
examination, while venous blood samples were drawn for estimation of metabolic
profile, levels of intact parathormone, phosphorus and calcium and osteopontin
(OPN). Arterial stiffness was estimated based on carotid-femoral pulse wave velocity
(PWV) measured with an automated device.
Results: After 1 year of treatment with paricalcitol compared to baseline there was no
statistical difference in levels of GFR (19.5±4.8 ml/min/1.73m² vs 18.0±2.3
ml/min/1.73m2, p=0.318) and calcium (9.11±2.3 vs 8.98±2.2 mg/dl, p=0.344).
Regarding the metabolic profile of patients, levels of glucose, lipids or uric acid did
not differ, while the product of calcium x phosphorus exhibited no pathological
values. Additionally, carotid-femoral PWV was reduced after 1 year treatment with
oral paricalcitol from 11.8±2.6 m/sec to 11.2±2.4 m/sec (p<0.05), while blood
pressure values and OPN levels 1 year after therapy compared to baseline values had
no statistical difference (p=NS).
Conclusions: Treatment with oral paricalcitol in hypertensive subjects suffering from
CKD stages 3-5 and secondary hyperparathyroidism is accompanied by amelioration
of arterial stiffness as reflected by the reduction of carotid-femoral PWV. These
findings suggest that paricalcitol exerts pleiotropic favorable effects on the vascular
system, thus improving cardiovascular prognosis in high risk hypertensive patients.

Health Sciences

CKD, Paricalcitol, Arterial stiffness, Hypertension, Osteopontin

No

0

Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/2819469