[Secondary hyperparathyroidism: incidence, clinical presentations, treatment].
Prevalence of secondary hyperparathyroidism (SHPT) was studied in 235 patients treated by program hemodialysis. SHPT was diagnosed according to recommendations of K/DOQI Clinical Practice Guidelines with the parathyroid hormone (PTH) level higher than 300 pg/ml. In the beginning of replacement renal therapy with hemodialysis the secondary hyperparathyroidism of different degree was found in 145 patients (61.7%): mild form (PTH from 300 to 450 pg/ml) in 37.8%, medium (PTH from 450 to 1000 pg/ml) in 40.5%, severe (PTH more than 1000 pg/ml) in 21.7%. Normal indices of PTH were determined in 70 patients. In 20 patients the parathyroid hormone was less than 120 pg/ml and they had symptoms of adynamic disease of the bones. In the group of patients observed for 4 years (n = 80) the incidence of SHPT became less against the background of treatment from 60.0% to 37.0%. Relatively satisfactory results of conservative treatment can be explained by predominance of patients with less than 5 years of CRF. The therapy was more effective in patients with mild and medium forms of SHPT. In patients with severe SHPT (PTH more than 1000 pg/ml) the effect was partial and 77.0% of these patients needed surgical treatment.
D015519:Bone Density; D002118:Calcium / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000379:methods*; D006435:Renal Dialysis / Q000379:methods*; D012426:Russia / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
D002118:Calcium