title: Clinical significance of parathyroid intervention on CKD-MBD management.
abstract: Recently published 'Guidelines for the management of secondary hyperparathyroidism in chronic dialysis patients' by the Japanese Society for Dialysis Therapy advocate that percutaneous ethanol injection into enlarged glands, which has been considered as the only alternative to parathyroidectomy (PTx), should be indicated in patients with a single enlarged parathyroid gland (estimated volume >500 mm(3), or estimated major axis >10 mm), and that PTx should be recommended in patients with multiple enlarged glands. Cinacalcet cannot achieve optimal control of chronic kidney disease-mineral bone disorder in all patients, and parathyroid intervention will be required in a considerable number of patients with refractory secondary hyperparathyroidism.
authors.affiliation: Department of Internal Medicine , Showa University Northern Yokohama Hospital , Yokohama.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ogata
authors.forename: Masahide
authors.initials: M
authors.lastname: Mizobuchi
authors.affiliation: Division of Nephrology, Department of Internal Medicine , Showa University Fujigaoka Hospital , Yokohama , Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Koiwa
authors.affiliation: Department of Internal Medicine , Showa University Northern Yokohama Hospital , Yokohama.
authors.forename: Eriko
authors.initials: E
authors.lastname: Kinugasa
authors.affiliation: Department of Nephrology , Showa University School of Medicine , Tokyo.
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa