| Theme |
Hypoparathyroidism and Related Problems in Dialysis Patients |
| Title |
Serum PTH concentration in dialysis and pre-dialysis patients with chronic renal failure |
| Author |
Tadao Akizawa |
Internal Medicine, Fujigaoka Hospital, Showa University |
| Author |
Fumihiko Koiwa |
Internal Medicine, Fujigaoka Hospital, Showa University |
| [ Summary ] |
PTH concentrations were reviewed in patients with chronic renal failure. High PTH levels were relatively frequently observed in long-term, young, non-diabetic dialysis patients. However, 60-75% of dialysis patients showed lower PTH levels than those required for normal bone metabolism of uremic bone which is resistant to PTH. Hypoparathyroidism (Hypo) tended to be observed in elderly, short term, diabetic dialysis patients. Other than these background factors, iatrogenic factors such as a high Ca concentration dialysate, excessive administration of vitamin D analogues or Ca salts, may contribute to the high incidence of Hypo. Low PTH concentrations were also noted even in patients with end-stage renal failure just before the initiation of dialysis. Approximately 20% with end-stage renal failure showed this Hypo state in our hospital. Careful attention should be paid to the increase in Hypo in the predialysis period, which is anticipated to increase due to the widespread use of vitamin D analogues. |