title: Effect of percutaneous calcitriol injection therapy on secondary hyperparathyroidism in uraemic patients.
abstract: 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.
authors.affiliation: Center of Blood Purification Therapy, Wakayama Medical University, Wakayama, Japan. shiizaki@wakayama-med.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shiizaki
authors.forename: Shigeo
authors.initials: S
authors.lastname: Negi
authors.forename: Masahide
authors.initials: M
authors.lastname: Mizobuchi
authors.forename: Ikuji
authors.initials: I
authors.lastname: Hatamura
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Narukawa
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kitabata
authors.forename: Shinji
authors.initials: S
authors.lastname: Sumikado
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
mesh_terms: 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*
chemical_list: D015415:Biomarkers; D002120:Calcium Channel Agonists; D010281:Parathyroid Hormone; D000469:Alkaline Phosphatase; D002117:Calcitriol