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


CONCLUSIONS
PCIT is a safe and effective treatment, which may also suppress parathyroid hyperplasia and improve bone turnover for refractory 2HPT.
Shiizaki
Kazuhiro
K
Center of Blood Purification Therapy, Wakayama Medical University, Wakayama, Japan. shiizaki@wakayama-med.ac.jp
Negi
Shigeo
S
Mizobuchi
Masahide
M
Hatamura
Ikuji
I
Narukawa
Nobuhiko
N
Sakaguchi
Toshifumi
T
Kitabata
Yukiko
Y
Sumikado
Shinji
S
Akizawa
Tadao
T
D000368:Aged; D000469:Alkaline Phosphatase / Q000378:metabolism; D015415:Biomarkers; D001842:Bone and Bones / Q000201:enzymology / Q000378:metabolism; D002117:Calcitriol / Q000008:administration & dosage*; D002120:Calcium Channel Agonists / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010280:Parathyroid Glands / Q000000981:diagnostic imaging; D010281:Parathyroid Hormone / Q000097:blood; D013997:Time Factors; D014463:Ultrasonography; D014511:Uremia / Q000150:complications*
D015415:Biomarkers; D002120:Calcium Channel Agonists; D010281:Parathyroid Hormone; D000469:Alkaline Phosphatase; D002117:Calcitriol