title: Value of serum alkaline phosphatase in evaluating hyperplasia of parathyroid glands in chronic hemodialysis patients.
abstract: To investigate the value of serum alkaline phosphatase in evaluating hyperplasia of parathyroid glands in hemodialysis patients, 28 hemodialysis patients who had parathyroid sonography examinations for secondary hyperparathyroidism were studied retrospectively. There were significant elevations of serum alkaline phosphatase, parathyroid hormone (PTH), serum total calcium, and dialysis duration in patients with sonography-detectable parathyroid (N = 17) as compared with those of sonography-undetectable (N = 11) parathyroid. Hemodialysis patients who have both higher serum alkaline phosphatase (> 94 IU/L) and considerably elevated serum PTH (9 x or higher) are likely to have sonography-detectable parathyroids (positive predictive value of 93%). Patients with mildly or moderately elevated serum PTH but normal serum alkaline phosphatase are less likely to have sonography-detectable parathyroids (negative predictive value is 100%). These findings suggest that the elevation of serum alkaline phosphatase could be a valuable parameter in addition to the high serum PTH level in predicting hyperplasia of parathyroid glands in chronic hemodialysis patients.
authors.affiliation: Department of Internal Medicine, Chang-Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Huang
authors.forename: B R
authors.initials: BR
authors.lastname: Hsu
authors.forename: B Y
authors.initials: BY
authors.lastname: Huang
authors.forename: H S
authors.initials: HS
authors.lastname: Huang
authors.forename: M J
authors.initials: MJ
authors.lastname: Huang
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging* / Q000209:etiology; D006965:Hyperplasia / Q000175:diagnosis; D008297:Male; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D000469:Alkaline Phosphatase