Journal Article

Effect of percutaneous calcitriol injection therapy on secondary hyperparathyroidism in uraemic patients

Kazuhiro Shiizaki, Shigeo Negi, Masahide Mizobuchi, Ikuji Hatamura, Nobuhiko Narukawa, Toshifumi Sakaguchi, Yukiko Kitabata, Shinji Sumikado and Tadao Akizawa

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 18, issue suppl_3, pages iii42-iii46
Published in print June 2003 | ISSN: 0931-0509
Published online June 2003 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfg1011
Effect of percutaneous calcitriol injection therapy on secondary hyperparathyroidism in uraemic patients

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Background. The impetus to develop percutaneous calcitriol injection therapy (PCIT) was the lack of therapeutic tools to treat secondary hyperparathyroidism (2HPT) resistant to medical therapy.

Methods. Nine dialysis patients resistant to intravenous calcitriol or calcitriol analogues underwent daily PCIT 5–10 times consecutively. The PCIT involved the injection of a volume of calcitriol equal to that of the enlarged parathyroid glands (PTGs) under ultrasonographic guidance. All patients had follow‐up intravenous calcitriol after PCIT.

Results. The serum intact PTH concentration was markedly reduced following PCIT and was maintained for 12 weeks with intravenous calcitriol without significant changes in serum adjusted calcium and phosphorus concentrations. All patients tolerated PCIT without serious adverse events. Serum bone alkaline phosphatase concentrations and the volume of the enlarged PTGs were also significantly reduced.

Conclusion. PCIT is a safe and effective treatment, which may also suppress parathyroid hyperplasia and improve bone turnover for refractory 2HPT.

Keywords: calcitriol; end‐stage renal disease (ESRD); interventional ultrasonography; renal osteodystrophy; secondary hyperparathyroidism

Journal Article.  2298 words.  Illustrated.

Subjects: Nephrology

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