Medical management after parathyroid intervention
Open Access
- 24 July 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Kidney Journal
- Vol. 1 (suppl 3), iii18-iii20
- https://doi.org/10.1093/ndtplus/sfn091
Abstract
Vitamin D or vitamin D analogues pulse therapy is seldom effective in patients with at least one parathyroid gland with nodular hyperplasia, and surgical parathyroidectomy or parathyroid intervention is indicated. In parathyroid interventions, especially in selective percutaneous ethanol injection therapy (PEIT), the enlarged parathyroid gland(s) with nodular hyperplasia is selectively destroyed by ethanol injection, while other glands with diffuse hyperplasia are managed by medical therapy. Thus, medical management, e.g., use of appropriate dose of vitamin D or vitamin D analogues after the PEIT procedure, is as important as the destruction of the hyperplastic tissue itself. Recent studies showed that the combination of PEIT and intravenous vitamin D pulse therapy lead to reduce serum PTH level and calcium-phosphorus products in haemodialysis patients. In this article, we focus on the importance of medical therapy after PEIT, and review the efficacy of the combination of PEIT and intravenous vitamin D pulse therapy for haemodialysis patients with secondary hyperparathyroidism.Keywords
This publication has 22 references indexed in Scilit:
- Ultrasound Patterns of Parathyroid Glands in Chronic Hemodialysis Patients with Secondary HyperparathyroidismAmerican Journal of Nephrology, 2008
- Efficacy of percutaneous ethanol injection therapy (PEIT) is related to the number of parathyroid glands in haemodialysis patients with secondary hyperparathyroidismNephrology Dialysis Transplantation, 2006
- Basic and clinical aspects of parathyroid hyperplasia in chronic kidney diseaseKidney International, 2006
- Is the Volume of the Parathyroid Gland a Predictor of Maxacalcitol Response in Advanced Secondary Hyperparathyroidism?Therapeutic Apheresis and Dialysis, 2006
- Guidelines for the management of secondary hyperparathyroidism in chronic dialysis patientsNihon Toseki Igakkai Zasshi, 2006
- Combination Therapy of Intravenous Maxacalcitol and Percutaneous Ethanol Injection Therapy Lowers Serum Parathyroid Hormone Level and Calcium × Phosphorus Product in Secondary HyperparathyroidismNephron Clinical Practice, 2005
- Percutaneous maxacalcitol injection therapy regresses hyperplasia of parathyroid and induces apoptosis in uremiaKidney International, 2003
- Parathyroid hormone, vitamin D, and cardiovascular disease in chronic renal failureKidney International, 1999
- Prognosis of parathyroid function after successful percutaneous ethanol injection therapy guided by color doppler flow mapping in chronic dialysis patientsAmerican Journal of Kidney Diseases, 1999
- Reduction of functioning parathyroid cell mass by ethanol injection in chronic dialysis patientsKidney International, 1994