PMID: 12771300May 29, 2003Paper

Efficacy of direct injection of calcitriol into the parathyroid glands in uraemic patients with moderate to severe secondary hyperparathyroidism

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Shohei NakanishiMasafumi Fukagawa

Abstract

Secondary hyperparathyroidism (2HPT) is a common complication in uraemic patients. When medical therapy, including high doses of intravenous calcitriol, fails to suppress the pathological secretion of parathyroid hormone (PTH), one of the newly developed interventional techniques, such as percutaneous ethanol injection therapy (PEIT), is an option before taking the surgical solution. A protocol for direct calcitriol injection therapy and a discussion of its effectiveness and limitations for an enlarged parathyroid gland(s) are presented. Nine patients were selected according to the Japanese Guideline for Selective PEIT. Using the same technique as PEIT, a dose of calcitriol that was approximately 200-300% of the calculated volume of the selected parathyroid gland was injected directly into the gland under ultrasonographic guidance. In six cases, the intact PTH concentration decreased to <360 pg/ml. The total volume of the enlarged parathyroid gland(s) also decreased to 54.7% of the initial volume. The blood supply to the treated glands, as evaluated by colour Doppler imaging, appeared to diminish transiently after injection, probably from the volume effect of this procedure. The number of enlarged parathyroid glands was not a l...Continue Reading

Citations

May 24, 2008·QJM : Monthly Journal of the Association of Physicians·C CappelliM Castellano
Feb 16, 2008·American Journal of Nephrology·Carlo VulpioMarco Castagneto
Apr 2, 2011·Clinical Journal of the American Society of Nephrology : CJASN·John CunninghamMariano Rodriguez
Aug 20, 2021·Curēus·Elmukhtar HabasAbdel-Naser Y Elzouki

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