Correlations between parameters of calcium metabolism and renin-angiotensin-aldosterone system in patients with primary hyperparathyroidism in the pre- and early postoperative periods

Background. Increasing evidence suggests a relationship between the renin-angiotensin-aldosterone system (RAAS) and parameters of calcium metabolism. Probably subclinical changes of the RAAS components activity could be predictors of cardiovascular pathology in patients with primary hyperparathyroidism (PHPT). Objective. To study the activity of the RAAS components and parameters of calcium metabolism in normotensive patients with symptomatic PHPT in the pre- and early postoperative periods. Design and methods. We performed a prospective non-comparative study of 35 patients with confirmed PHPT without concomitant cardiovascular diseases and their traditional risk factors. Patients who took drugs affecting calcium metabolism and RAAS were also excluded. In all patients we assessed the main biochemical and hormonal parameters of calcium metabolism and RAAS preoperatively and 3 days after parathyroidectomy. Results. Normotensive patients with PHPT did not show any correlations of parathyroid hormone and serum calcium levels with RAAS components either before surgery or in early postoperative period, however, a significant decrease in serum aldosterone level was observed 3 days after successful parathyroidectomy (p = 0,004). Conclusions. Further investigation is required to clarify the relationship between calcium metabolism and the RAAS and to identify possible predictors of cardiovascular pathology in PHPT.

primary hyperparathyroidism, calcium metabolism disorders, hypertension, normotension, renin-angiotensin system, aldosterone

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