title: Effectiveness of weekly percutaneous maxacalcitol injection therapy in patients with secondary hyperparathyroidism.
abstract: Percutaneous injection therapy with vitamin D has been applied in the treatment of hyperparathyroidism (HPT); however, the application of percutaneous injection therapy with vitamin D lacks established guidelines regarding the volume of injected solution and the frequency of injection. We have developed an outpatient treatment regimen using percutaneous maxacalcitol injection therapy (PMIT) on a weekly basis for 4-6 weeks following dialysis without major complications. Intact parathyroid hormone decreased from 797 +/- 178 pg/mL to 253 +/- 25 pg/mL, and the parathyroid gland volume initially increased during the first week, but thereafter, it gradually decreased with weekly PMIT (wPMIT). Finally, the parathyroid gland volume decreased from 1.27 +/- 1.06 cm(3) to 0.24 +/- 0.15 cm(3) after wPMIT. The benefits of our method were confirmed on weekly ultrasonographic examinations, which detailed the gradual reduction in gland size following an initial increase after the first injection. Therefore, we conclude that our carefully implemented PMIT method would be an effective treatment against refractory secondary HPT.
authors.affiliation: Department of Nephrology, Kanazawa Medical University Himi Municipal Hospital, Toyama, Japan. atsu@kanazawa-med.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Yuhta
authors.initials: Y
authors.lastname: Oyama
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Asaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yokoyama
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood / Q000187:drug effects; D016588:Anticarcinogenic Agents / Q000097:blood / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood / Q000187:drug effects; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000187:drug effects; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D006435:Renal Dialysis; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D016588:Anticarcinogenic Agents; D015415:Biomarkers; D010281:Parathyroid Hormone; D015675:Osteocalcin; D010758:Phosphorus; D000469:Alkaline Phosphatase; D002117:Calcitriol; C051883:maxacalcitol; D002118:Calcium