Combination Therapy of Intravenous Maxacalcitol and Percutaneous Ethanol Injection Therapy Lowers Serum Parathyroid Hormone Level and Calcium × Phosphorus Product in Secondary Hyperparathyroidism

Tanaka, Motoko; Itoh, Kazuko; Matsushita, Kazunori; Matsushita, Kazutaka; Fukagawa, Masafumi

doi:10.1159/000088163

Cited by 11 publications

(8 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was possible to maintain good parathyroid function after PEIT until the end of surveillance by using the medical treatments together [ 20 ]. The criteria were different from those for the acquisition of the effectiveness within 1 year.…”

Section: Discussionmentioning

confidence: 99%

Long-term prognosis of parathyroid function in chronic dialysis patients after PEIT--a single-centre trial

Tanaka

Kakuta

Koiwa

et al. 2008

Clinical Kidney Journal

View full text Add to dashboard Cite

Background. Secondary hyperparathyroidism (SHPT) is a common complication observed in long-term dialysis patients. Percutaneous ethanol injection therapy (PEIT) of parathyroid glands (PTGs) is now established in Japan as a treatment option for SHPT. In this study, to elucidate the factors influencing efficacy in 1 year and relapse following PEIT, we analysed the long-term prognosis of parathyroid function that is known to have the greatest effect on therapeutic results.Methods. The study design was a retrospective cohort study. We studied 104 patients with SHPT, who underwent PEIT at Tokai University Hospital between January 1993 and December 2002, and we followed them up until January 2008. The effective group reached intact parathyroid hormone of 200 pg/ml or less, corrected calcium (Ca) of 10.5 mg/dl or less and phosphate (P) of 6.0 mg/dl or less. The ineffective group failed to achieve these criteria.Results. Among the 104 patients, 66 patients (63%) fulfilled the criteria for the effective group within the first year of PEIT. Using the multivariate logistic regression analysis, the number of PTGs before PEIT was a significant risk factor to deviate from the criteria. At the end of the surveillance period, 31 patients (30%) fulfilled the criteria, and their SHPT was controlled with PEIT. Using the multivariate logistic regression analysis, more than three PTGs at the beginning, and the increase in PTGs during the observation period were significant risk factors to deviate from the criteria. In conclusion, superior results with PEIT are obtained in terms of efficacy, remission period and risk of relapse, regardless of the size of the gland.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-term prognosis of parathyroid function in chronic dialysis patients after PEIT--a single-centre trial

Tanaka

Kakuta

Koiwa

et al. 2008

Clinical Kidney Journal

View full text Add to dashboard Cite

show abstract

“…However, PDIT seems to have a moderate effect when compared with PEIT [105]. A combined therapy of intravenous maxacalcitol and ethanol injection has been proved to be successful for the management of SHPT [111].…”

Section: Percutaneous Direct Injection Therapymentioning

confidence: 99%

Advances in pharmacotherapy for secondary hyperparathyroidism

Rodríguez

Rodríguez‐Ortiz

2015

Expert Opinion on Pharmacotherapy

View full text Add to dashboard Cite

PTH increases from early stages of renal disease. One of the goals in pre-dialysis is the prevention of hyperphosphatemia and the maintenance of Ca levels in the normal range. The management of hyperparathyroidism in dialysis requires control of phosphorus level. In this stage, the decision to use calcimimetics and vitamin D derivatives should be made according to serum levels of Ca and phosphorus.

show abstract

“…The most popular is hyperbaric oxygen therapy, which counteracts tissue hypoxia by supplying high concentrations of oxygen. Benefit has been shown in patients who underwent repeated treatment (range 20-108 sessions, generally 20 through 40) with 100% oxygen applied at 2.5 standard atmospheres for 90 minutes [54]. Visible ulcer healing was observed between 3 and 7 weeks after initiating therapy.…”

Section: Management Of the Patientsmentioning

confidence: 99%

Calciphylaxis – A Rare Devastating Condition Associated with Chronic Kidney Disease

Mahesh¹,

'²,

G.C³

et al. 2012

J Nephrol Therapeutic

View full text Add to dashboard Cite

Calciphylaxis, a rare, life threatening disease, usually observed in patients with chronic kidney disease and characterised by typical skin lesions -violaceous, reticulate areas of cutaneous necrosis particularly in the extremities, raised calcium phosphorous product, elevated parathyroid hormone level, histopathologically skin biopsies shows mural calcification affecting small arterioles and radiographic evidence of blood vessel and soft-tissue calcification.Calciphylaxis is a small-vessel vasculopathy, reported to occur in about 1-4% of haemodialysis patients. Disease is associated with a high mortality which ranges from 60-80% and relates to wound infection, sepsis and organ failure. Prolonged hyperphosphatemia and/or elevated calcium phosphorus products, Protein malnutrition, warfarin use and hypercoagulable states, such as protein C and/or protein S deficiency are associated with increased risk of the disease.Clinically, many dermatologic conditions resemble the skin lesions of Calciphylaxis but can be discern by careful clinical evaluation of patient and histopathological examination of skin biopsy. Different therapeutic agents have been reported for the treatment of this condition with variable results. Therapeutic goals are guided by controlling levels of parathyroid hormone, calcium, phosphate, and the calcium-phosphate product within the normal range. A high index of suspicion and an active multidisciplinary management approach, with rigorous attention to wound care and prevention of sepsis, are vital steps in the management of these patients.In this overview, we discuss the pathophysiology, clinical features, risk factors, and diagnosis and management issues relating to Calciphylaxis. This review is of interest to Medical specialist-specially to Dermatologist and Nephrologists for early identification of disease and therapeutic intervention.

show abstract

Combination Therapy of Intravenous Maxacalcitol and Percutaneous Ethanol Injection Therapy Lowers Serum Parathyroid Hormone Level and Calcium × Phosphorus Product in Secondary Hyperparathyroidism

Cited by 11 publications

References 61 publications

Long-term prognosis of parathyroid function in chronic dialysis patients after PEIT--a single-centre trial

Long-term prognosis of parathyroid function in chronic dialysis patients after PEIT--a single-centre trial

Advances in pharmacotherapy for secondary hyperparathyroidism

Calciphylaxis – A Rare Devastating Condition Associated with Chronic Kidney Disease

Contact Info

Product

Resources

About