| Theme |
Intervention of parathyroid |
| Title |
Percutaneous ethanol injection into parathyroid gland in chronic renal failure patients |
| Author |
Noritaka Onoda |
Division of Nephrology, Kasukabe Shuwa Hospital |
| Author |
Satoshi Kurihara |
Division of Nephrology, Kasukabe Shuwa Hospital |
| [ Summary ] |
Ten years have already passed since PEIT (percutaneous ethanol injection therapy) was first used to treat a Japanese patient with chronic renal failure. Since then, PEIT has become an established therapeutic alternative to PTx (parathyroidectomy). In 2000, a guideline for PEIT was published by the Japanese Working Group on PEIT for the Parathyroid. The most favorable indication is for patients with fewer than two parathyroid glands measuring more than 1cm in length. Aged patients and high risk patients who are intolerant to surgical procedures are also indicated. Some recurrent cases after PTx respond to PEIT. To perform the technique with utmost reliability, the use of high-resolution ultrasonography is essential. To avoid hoarseness due to recurrent nerve palsy, it is also necessary to visually confirm the needle tip and ethanol micro-bubble jet echo during the injection. Post PEIT medical therapy including vitamin D administration and serum phosphorus control are also important. |