| Theme |
Interventional Radiology for Dialysis Patients |
| Title |
Parathyroid intervention : percutaneous injection therapy (PIT) and parathyroidectomy (PTx) for advanced renal hyperparathyroidism |
| Author |
Takatoshi Kakuta |
Department of Internal Medicine, Tokai University School of Medicine |
| [ Summary ] |
Marked parathyroid hyperplasia is a characteristic feature of severe hyperparathyroidism in patients requiring chronic hemodialysis. Most of these patients become resistant to conservative therapies, including calcitriol pulse therapy. For these patients, surgical removal of enlarged parathyroid glands (PTx) is usually needed to control parathyroid hormone secretion. Percutaneous ethanol injection therapy (PEIT) of the parathyroid was originally introduced as an alternative to PTx. “Selective PEIT of the parathyroid glands” was later developed, in which enlarged parathyroid glands with nodular hyperplasia are “selectively” destroyed by ethanol injection, and other glands with diffuse hyperplasia are then managed by medical therapy. “Selective PEIT” for advanced renal hyperparathyroidism in Japan is discussed. |