Treatment of uremic hyperparathyroidism with percutaneous ethanol injection.
The percutaneous ethanol injection (PEI) with ultrasound guidance has been suggested for the treatment of patients with hyperparathyroidism who are on dialysis, with the aim of selectively treating the parathyroid glands with nodular hyperplasia. We present our experience in 25 patients with chronic renal failure followed during 13.4 +/- 10.6 months. A decrease in the levels of parathormone (PTH) (1,236.32 +/- 129.8 vs. 721.66 +/- 142.24 pg/ml), phosphatemia (6.16 +/- 0.35 vs. 4.93 +/- 0.36 mg/dl) and calcium-phosphorous product (60.82 +/- 3.81 vs. 46.47 +/- 3.46 mg2/dl2) was verified. In 56% of patients, PTH levels decreased (>50% of the baseline value) and 36% had final values <300 pg/ml. Patients in whom ultrasound showed a single gland responded better than those with more than one gland (83.3 vs. 30.8% of responders in each group). The procedures performed had a 4.9% complication rate: hematoma, symptomatic hypocalcemia, temporary paresis of the vocal cords. In summary, treatment with PEI is useful for the management of patients with hyperparathyroidism who are on dialysis, and the results achieved are better in patients who have a single gland identified by ultrasonography.
Fassi
Juliana
J
Department of Endocrinology, Metabolism and Nuclear Medicine, Hospital Italiano, Buenos Aires, Argentina.
Lambertini
Roberto
R
Farias
Patricia
P
Blejman
Oscar
O
Rosa Diez
Guillermo
G
Algranati
Salomon
S
Plantalech
Luisa
L
D000328:Adult; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000188:drug therapy*; D007267:Injections; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D014511:Uremia / Q000188:drug therapy* / Q000209:etiology
D000431:Ethanol