This article appears in the following NDT Plus issue: Parathyroid Intervention - Current themes and future perspectives [View the issue table of contents]
Clinical significance of parathyroid intervention on CKD-MBD management
1 Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama
2 Department of Nephrology, Showa University School of Medicine, Tokyo
3 Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
Correspondence: Hiroaki Ogata, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Chigasaki-chuo 35-1, Tsuzuki, Yokohama 224-8503, Japan. Tel: +81-45-949-7000; Fax: +81-45-949-7927; E-mail: ogatah{at}med.showa-u.ac.jp
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Abstract |
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Recently published ‘Guidelines for the management of secondary hyperparathyroidism in chronic dialysis patients’ by the Japanese Society for Dialysis Therapy advocate that percutaneous ethanol injection into enlarged glands, which has been considered as the only alternative to parathyroidectomy (PTx), should be indicated in patients with a single enlarged parathyroid gland (estimated volume >500 mm3, or estimated major axis >10 mm), and that PTx should be recommended in patients with multiple enlarged glands. Cinacalcet cannot achieve optimal control of chronic kidney disease–mineral bone disorder in all patients, and parathyroid intervention will be required in a considerable number of patients with refractory secondary hyperparathyroidism.
Received for publication March 8, 2008. Accepted for publication March 10, 2008.