| Theme |
Evidence-based strategies for secondary hyperparathyroidism |
| Title |
Limitation of medical treatments for secondary hyperparathyroidism |
| Author |
Kazuhiro Shiizaki |
Center of Blood Purification Therapy, Wakayama Medical University |
| Author |
Masanori Okamoto |
Center of Blood Purification Therapy, Wakayama Medical University |
| Author |
Tadao Akizawa |
Center of Blood Purification Therapy, Wakayama Medical University |
| [ Summary ] |
Secondary hyperparathyroidism (2ndry HPT) is an important disorder determining the survival and quality of life (QOL) for dialysis patients. For the prevention and management of 2ndry HPT, calcium-free phosphate binders and vitamin D analogues with mild calcemic action have been developed. However, many patients with severely advanced 2ndry HPT are still resistant to these treatments. The continuation of medical treatments for those patients with severe 2ndry HPT is not adequate because 2ndry HPT conditions not only deteriorate 2ndry HPT and bone disease but also progress ectopic calcification. In particular, the calcification of blood vessels and cardiac valves, may worsen the prognosis and QOL for dialysis patients. It is necessary to accurately determine the limitations of medical treatments for 2ndry HPT patients by examining laboratory data and a performing image analysis of the parathyroid periodically. Recently developed whole PTH assay is expected to be useful in making these determinations also. |