| Theme |
Hypoparathyroidism and Related Problems in Dialysis Patients |
| Title |
Reasonable management for optimal parathyroid function |
| Author |
Eisei Noiri |
First Department of Internal Medicine, The University of Tokyo School of Medicine |
| Author |
Masafumi Fukagawa |
First Department of Internal Medicine, The University of Tokyo School of Medicine |
| Author |
Kiyoshi Kurokawa |
Tokai University, Faculty of Medicine |
| [ Summary ] |
The management of secondary hyperparathyroidism (2° HPT) in chronic dialysis patients has been progressed remarkably due to elucidation the biological properties of PTH, calcium, phosphate and vitamin D and their metabolism. Based on these knowledges, the efficacy of supraphysiological doses of 1,25(OH)2D3 on 2° HPT was clarified, while the issues of unresponsive cases and of bone metabolism should appropriately considered at the same time. It is feasible to predict the effectiveness and limitations of 1,25(OH)2D3 pulse therapy in advance for each case using combinations of routine data including the side of parathyroid glands. This review addresses the background and pitfall of managing parathyroid function in chronic dialysis patients. |