| [ Summary ] |
In patients with chronic renal failure, calcitriol deficiencies cause down regulation of vitamin D receptor, and set point shifts to the right. The target of intravenous maxacalcitol or calcitriol pulse therapy is to shift the set point to the left. If the level of intact PTH is not suppressed to the target level when hypercalcemia occurs in patients undergoing IVPT, there is the possibility that intact PTH may not be suppressed at the same time and IVPT may be terminated. Usually, such patiens have more than one parathyroid gland with nodular hyperplasia, and should be indicated for percutaneous ethanol injection therapy or total parathyroidectomy with forearm auto grafts. |