Is There an Association between Neoplasia and Primary or Secondary Hyperparathyroidism?

Kopple, Joel D.; Massry, Shaul G.

doi:10.1159/000167651

Cited by 15 publications

(5 citation statements)

References 48 publications

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“…In 4 surgical series the incidence ranged between 16 and 34%, while carcinomas were found in 42% of the cases in an autopsy series [44,45]. In particular, malignancies of the thyroid, breast, and gastrointestinal tract were linked with primary hyperparathyroidism.…”

Section: Parathyroid Hormone Excess and Deficiency Of 125-dihydroxycmentioning

confidence: 98%

Cancer in End-Stage Renal Disease: Potential Factors Involved

Vamvakas

Bahner²,

Heidland³

1998

Am J Nephrol

166

113

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Increased incidence of cancer at various sites is observed in patients with end-stage renal disease (ESRD). In particular, lymphomas and carcinomas of the kidney, prostate, liver and uterus show an enhanced prevalence in these subjects compared with the general population. A multitude of factors directly or indirectly associated with the renal disease and the treatment regimens may contribute to the increased tumor formation in these patients. Impaired function of the immune system and of DNA repair mechanisms as well as reduced antioxidant defense, accumulation of carcinogenic compounds partly due to reduced renal elimination as well as chronic infections and inflammations are found more frequently in patients with ESRD compared with the general population and may act in concert to accelerate malignant transformation and tumor formation.

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Section: Parathyroid Hormone Excess and Deficiency Of 125-dihydroxycmentioning

confidence: 98%

Cancer in End-Stage Renal Disease: Potential Factors Involved

Vamvakas

Bahner²,

Heidland³

1998

Am J Nephrol

166

113

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“…Hence, there is concern that GH might induce cancer or promote cancer proliferation. This is particularly relevant because there is increased risk of cancer in ESRD patients (48). Indeed, in people not previously treated with GH, spontaneously high serum IGF-I levels and/or low levels of IGF-binding protein-3 are associated with increased risk of several cancers, including breast, colon, prostate, and lung cancer (49).…”

Section: Safety Aspects Of Ghmentioning

confidence: 99%

Opportunity™

Kopple¹,

Cheung²,

Christiansen³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background: The mortality rate of maintenance hemodialysis (MHD) patients remains high. Measures of protein-energy wasting, including hypoalbuminemia, are strongly associated with their high mortality. Growth hormone (GH) may improve lean body mass (LBM) and serum albumin levels, and health-related quality of life (HRQoL), which are significantly and positively associated with survival in MHD patients. The OPPORTUNITY TM Trial will examine whether GH reduces mortality and morbidity and improves overall health in hypoalbuminemic MHD patients.Hypothesis: The primary hypothesis is that daily recombinant human GH injections, compared with placebo, improve survival in hypoalbuminemic MHD patients. Secondary hypotheses are that GH improves morbidity and health, including number of hospitalized days, time to cardiovascular events, LBM, serum protein and inflammatory marker levels, exercise capacity, and HRQoL, and has a favorable safety profile.Design/Measurements: This is a prospective, double-blind, multicenter, randomized clinical trial involving 2500 MHD patients, up to 50% with diabetes mellitus, from 22 countries. Patients are randomized in a 1:1 ratio to receive daily injections of GH (20 g/kg per day) or placebo for 104 weeks. Key inclusion criteria include clinically stable and well-dialyzed (Kt/V >1.2) adult MHD patients with serum albumin <4.0 g/dl. Exclusion criteria include active malignancy, active proliferative or severe nonproliferative diabetic retinopathy, uncontrolled hypertension, chronic use of high-dose glucocorticoids, or immunosuppressive agents and pregnancy.Conclusions: The OPPORTUNITY TM Trial is the first large-scale randomized clinical trial in adult MHD patients evaluating the response to GH of such clinical endpoints as mortality, morbidity, markers of body protein mass, inflammation, exercise capacity, and HRQoL.

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“…Studies in primary hyperparathyroidism have shown an incidence of thyroid nodules or goiter in over 20% of patients at surgery and in over 60% at autopsy (19). An increase in malignant and non-malignant thyroid lesions occurs in primary hyperparathyroidism (20,21). The parallel increase in secondary hyperparathyroidism and goiter incidence is consistent with the proliferative properties of PTH 7, lending credence to a role for PTH in the genesis of uremic goiter.…”

Section: Uremic Goiter: the Malevolent Iodidementioning

confidence: 84%

“…Chronic iodine excess is likely to be a predisposing factor for various minor goitrogens. The reports of thyroid malignancy in dialysis patients (20,21,22) deserve greater scrutiny, and suggest that uremic goiter cannot be said at this time to be definitely benign.…”

Section: Uremic Goiter: the Malevolent Iodidementioning

confidence: 99%

Uremic Goiter: The Malevolent Iodide

1991

Int J Artif Organs

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Is There an Association between Neoplasia and Primary or Secondary Hyperparathyroidism?

Cited by 15 publications

References 48 publications

Cancer in End-Stage Renal Disease: Potential Factors Involved

Cancer in End-Stage Renal Disease: Potential Factors Involved

Opportunity™

Uremic Goiter: The Malevolent Iodide

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