The activity of the renin-angiotensin-aldosterone system before and after parathyroidectomy in patients with primary hyperparathyroidism
- Authors: Yanevskaya L.G.1, Pogosian K.A.1, Semenova A.N.2, Chernikov R.A.3, Buzanakov D.M.3, Belyaeva O.D.1,2, Grineva E.N.1,2, Karonova T.L.1,2
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Affiliations:
- Almazov National Medical Research Centre
- Pavlov First Saint Petersburg State Medical University
- Saint Petersburg State University Pirogov Clinic of High Medical Technologies
- Issue: Vol 23, No 12 (2021)
- Pages: 914-919
- Section: Articles
- URL: https://journals.rcsi.science/2075-1753/article/view/100015
- DOI: https://doi.org/10.26442/20751753.2021.12.201235
- ID: 100015
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Abstract
Background. The relationships between renin-angiotensin-aldosterone system (RAAS) and elevated parathyroid hormone levels in primary hyperparathyroidism (PHPT) is being actively discussed. But the way how parathyroid hormone interacts with renin and aldosterone currently is not clear.
Materials and methods. Forty patients aged 18 to 70 years with a confirmed diagnosis of PHPT were involved in the study. All patients were tested for the main parameters of phosphorus-calcium metabolism and the RAAS parameters (plasma renin, plasma aldosterone) before and 2 weeks after parathyroidectomy.
Results. Sixty percent of patients had any cardiovascular disease (CVD) and hypertension was the most common. Patients CVD in comparison with patients without CVD were older (61 and 41 years, respectively; p<0.001), had a higher body mass index (28.9 and 21.9 kg/m2, respectively; p<0.001) and had a lower aldosterone-to-renin ratio – ARR (1.78 and 5.42, respectively; p=0.030). Patients with hypertension were older than patients with normal blood pressure (63 and 41 years, respectively; p<0.001), had a higher body mass index (28.1 and 23.5 kg/m2, respectively; p=0.005), a lower ARR (1.46 and 5.82, respectively; p=0.001), as well higher levels of plasma renin (109.2 and 20.3 pg/ml, respectively; p=0.007) and serum total calcium (2.84 and 2.71 mmol/l, respectively; p=0.041). Correlation analysis showed that in patients with PHPT and CVD, the concentration of aldosterone is associated with the level of 24-hour urinary calcium (r=0.829, p=0.042), and in patients with symptomatic PHPT and CVD, the level of aldosterone correlated with the level of ionized calcium (r=-0.812, p=0.05). We found no significant differences between the levels of renin, aldosterone and ARR before and 2 weeks after parathyroidectomy. However, in the postoperative period, there were no differences in the levels of renin and ARR among patients with hypertension and without hypertension.
Conclusion. In our study we found that the levels of plasma renin and serum total calcium were higher in patients with PHPT and hypertension compared to patients with normal blood pressure. Also, we found the associations between plasma aldosterone and levels of ionized calcium and 24-hour urinary calcium. But the relationships between RAAS parameters and parameters of phosphorus-calcium metabolism need further investigations.
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##article.viewOnOriginalSite##About the authors
Liubov G. Yanevskaya
Almazov National Medical Research Centre
Author for correspondence.
Email: fosterthefire@yandex.ru
ORCID iD: 0000-0003-2271-8139
SPIN-code: 1359-2238
Graduate Student
Russian Federation, Saint PetersburgKarina A. Pogosian
Almazov National Medical Research Centre
Email: karina.a.pogosyan@gmail.com
ORCID iD: 0000-0003-0628-0085
SPIN-code: 3977-7644
Res. Assist.
Russian Federation, Saint PetersburgAlisa N. Semenova
Pavlov First Saint Petersburg State Medical University
Email: foxberry451@gmail.com
ORCID iD: 0000-0001-6570-6459
student
Russian Federation, Saint PetersburgRoman A. Chernikov
Saint Petersburg State University Pirogov Clinic of High Medical Technologies
Email: yaddd@yandex.ru
ORCID iD: 0000-0002-3001-664X
SPIN-code: 7093-1088
D. Sci. (Med.)
Russian Federation, Saint PetersburgDmitrii M. Buzanakov
Saint Petersburg State University Pirogov Clinic of High Medical Technologies
Email: dmitrybuzanakov@gmail.com
ORCID iD: 0000-0001-8350-8376
Graduate Student
Russian Federation, Saint PetersburgOlga D. Belyaeva
Almazov National Medical Research Centre; Pavlov First Saint Petersburg State Medical University
Email: olgad.bel@gmail.com
ORCID iD: 0000-0002-5349-2227
SPIN-code: 8836-4768
D. Sci. (Med.)
Russian Federation, Saint Petersburg; Saint PetersburgElena N. Grineva
Almazov National Medical Research Centre; Pavlov First Saint Petersburg State Medical University
Email: grineva_e@mail.ru
ORCID iD: 0000-0003-0042-7680
SPIN-code: 2703-0841
D. Sci. (Med.)
Russian Federation, Saint Petersburg; Saint PetersburgTatiana L. Karonova
Almazov National Medical Research Centre; Pavlov First Saint Petersburg State Medical University
Email: karonova@mail.ru
ORCID iD: 0000-0002-1547-0123
SPIN-code: 3337-4071
D. Sci. (Med.)
Russian Federation, Saint Petersburg; Saint PetersburgReferences
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