Results of the Dynamic Cohort Study of Parathyroid Gland Function in Patients with Secondary Hyperparathyroidism
In 92 patients with end-stage chronic kidney disease we have evaluated serum levels of parathyroid hormone (PTH), vitamin D3, indicators of phosphorus and calcium metabolism and markers of bone metabolism: at baseline and at the end of dynamic follow-up period lasting from 6 to 24 months. In the whole group the mean PTH level and incidence of secondary hyperparathyroidism (SHPT) have not changed significantly. Phosphorus levels decreased significantly, but did not reach the target level, indicating the lack of patients’ adherence to medical recommendations on hyperphosphatemia correction. It was found that the persistence of high levels of PTH during follow-up is determined by high baseline levels of PTH, alkaline phosphatase, osteocalcin and beta-cross-laps, as well as the young age of the patients. Persistence of hypercalcemia and hyperphosphatemia has the greatest impact on SHPT aggravation. The findings allow us to conclude that in patients with stable parameters of phosphorus and calcium metabolism, with the absence of correction for calcium and phosphorus metabolism or use of diet in combination with calcium and vitamin D3 preparations, the measurement of PTH once a year in most cases is enough to control its levels.
Felsenfeld A.J., Rodrıguez M., Aguilera-Tejero E. Dynamics of Parathyroid Hormone Secretion in Health and Secondary Hyperparathyroidism // Clin. J. Am. Soc. Nephrol. — 2007. — Vol. 2. — P. 1283-1305.
Horl W.H. The clinical consequences of secondary hyperparathyroidism: focus on clinical outcomes // Nephrol. Dial. Transplant. — 2004. — Vol. 19, Suppl. 5. — V. 2-8.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD) // Kidney International. — 2009. — № 76(Suppl. 113). — S1-S130.
Lim S., Gun N.T. Secondary hyperparathyroidism and calcium phosphate control in a hemodialysis population // Acta Med. Indones. — 2007. — Vol. 39(2). — P. 71-74.
Maduell F., Gorriz J.L., Pallardo L.M., Pons R., Santiago C. Assessment of phosphorus and calcium metabolism and its clinical management in hemodialysis patients in the community of Valencia // J. Nephrol. — 2005. — Vol. 18(6). — Р. 739-748.
Mereu M.C., Bolasco P.G., Pinna A., Carzedda L.G., Branca G.F., Di Lauro L., Cogoni G., Solinas R., Mureddu S. The treatment of osteodystrophy in dialyzed uremic patients: results of the first Sardinian audit // G. Ital. Nefrol. — 2004. — Vol. 21(4). — P. 362-370.
Moe S.M., Drueke T., Cunningham J. et al. Definition, evaluation, and classification of renal osteodystrophy: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO) // Kidney International. — 2006. — Vol. 69. — P. 1945-1953.
Moe S.M., Drueke T., Lameire N., Eknoyan G. Chronic kidney disease — mineral-bone disorder: a new paradigm // Adv. Chronic. Kidney Dis. — 2007. — Vol. 14(1). — P. 3-12.
National Kidney Foundation Dialysis Outcomes Quality Initiative (K/DOQI) guidelines // http://www.kidney.org/professionals/kdoqi/guidelines_bone/index.htm
Schomig M., Ritz E. Management of disturbed calcium metabolism in uraemic patients: use of vitamin D metabolites // Nephrol. Dial. Transplant. — 2000. — Vol. 15(Suppl. 5). — P. 18-24.
Schomig M., Ritz E. Management of disturbed calcium metabolism in uraemic patients: indications for parathyroidectomy // Nephrol. Dial. Transplant. — 2000. — Vol. 15(Suppl. 5). — P. 25-29.
Wei M., Taskapan H., Esbaei K., Jassal S.V., Bargman J.M., Oreopoulos D.G. K/DOQI guideline requirements for calcium, phosphate, calcium phosphate product, and parathyroid hormone control in dialysis patients: can we achieve them? // Int. Urol. Nephrol. — 2006. — Vol. 38(3–4). — P. 739-743.
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