Dynamic changes of renin-angiotensin-aldosterone system parameters after surgery of primary hyperparathyroidism

E. A. Dobreva; Добрева Екатерина Александровна; E. E. Bibik; Бибик Екатерина Евгеньевна; A. K. Eremkina; Еремкина Анна Константиновна; A. R. Ajnetdinova; Айнетдинова Алина Ринатовна; L. V. Nikankina; Никанкина Лариса Вячеславовна; N. M. Malysheva; Малышева Наталья Михайловна; N. G. Mokrysheva; Мокрышева Наталья Георгиевна

doi:10.26442/00403660.2020.10.000725

Dynamic changes of renin-angiotensin-aldosterone system parameters after surgery of primary hyperparathyroidism

Authors: Dobreva E.A.¹, Bibik E.E.¹, Eremkina A.K.¹, Ajnetdinova A.R.¹, Nikankina L.V.¹, Malysheva N.M.¹, Mokrysheva N.G.¹
Affiliations:
1. Endocrinology Research Centre
Issue: Vol 92, No 10 (2020)
Pages: 63-69
Section: Original articles
URL: https://journals.rcsi.science/0040-3660/article/view/50983
DOI: https://doi.org/10.26442/00403660.2020.10.000725
ID: 50983

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Abstract

Aim. To study an activity of the Renin-Angiotensin-Aldosterone System (RAAS) components in patients with primary hyperparathyroidism (PHPT) before and after parathyroidectomy (PTE).

Materials and methods. A comparative study of patients with PHPT and control group. The first stage of the study included 56 patients with PHPT (group 1) before and on the third day after PTE. The second stage was carried out in 27 patients with remission of PHPT (group 2). All patients and healthy volunteers were tested for the main parameters of phosphorus-calcium metabolism and the RAAS parameters (plasma renin activity – PRA, serum aldosterone, angiotensin II – AT II).

Results. Patients with active PHPT demonstrated changes in RAAS activity (lower PRA, higher AT II level) comparing to control group, that have statistical significance in group 1 (p<0.001 for both parameters). There were no significant differences in aldosterone levels (p₁=0.090; p₂=0.140). On the third day after PTE (group 1), a decrease in aldosterone level (p=0.009) and a tendency to decrease in PRA (p=0.030) were detected. However, an increase in PRA (p=0.018), a decrease in AT II concentration (p=0.032) comparing to the initial values and their normalization were observed 12 months after surgery when permanent normal serum calcium and PTH levels had been achieved. There were controversial correlations between the parameters of phosphorus-calcium metabolism and RAAS. The influence of angiotensin-converting-enzyme inhibitors and AT II receptor blockers on phosphorus-calcium metabolism in patients with PHPT was not observed.

Conclusion. In patients with PHPT, there were no сlear correlations of phosphorus-calcium metabolism parameters with RAAS, however an increase of AT II concentration was noted, that can take part in a development of hypertension for this endocrinopathy. PTE can have a positive effect on AT II level.

Keywords

primary hyperparathyroidism, renin-angiotensin-aldosterone system, parathyroid hormone, aldosterone, angiotensin II, hypertension

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чл.-кор. РАН, д.м.н., проф., дир. ФГБУ

Russian Federation, Moscow

References

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