Effects of Pamidronate and Calcitriol on the Set Point of the Parathyroid Gland in Postmenopausal Hemodialysis Patients with Secondary Hyperparathyroidism

2012 ◽  
Vol 122 (3-4) ◽  
pp. 93-101 ◽  
Author(s):  
Chung-Yu Huang ◽  
Cai-Mei Zheng ◽  
Chia-Chao Wu ◽  
Lan Lo ◽  
Kuo-Cheng Lu ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Hemodialysis Patients ◽  
Set Point

Decreases in Parathyroid Gland Volume after Cinacalcet Treatment in Hemodialysis Patients with Secondary Hyperparathyroidism

2010 ◽  
Vol 115 (3) ◽  
pp. c195-c202 ◽  
Author(s):  
Mitsuru Ichii ◽  
Eiji Ishimura ◽  
Senji Okuno ◽  
Hidenori Chou ◽  
Yoko Kato ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Hemodialysis Patients ◽  
Gland Volume

Assessing acute parathyroid responsiveness in hemodialysis patients by measuring intact parathyrin in pre- and post-dialysis serum

1991 ◽  
Vol 37 (7) ◽  
pp. 1216-1220 ◽  
Author(s):  
Beverly A Dilena ◽  
Graham H White
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Whole Blood ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Total Calcium ◽  
Dialysis Patients ◽  
Intact Pth ◽  
Set Point ◽  
Patients At Risk ◽  
Analytical Imprecision

Abstract We measured pre- and post-dialysis concentrations of ionized calcium (iCa) in whole blood, total calcium (tCa) in plasma, and intact parathyrin (PTH) in serum of 19 patients undergoing maintenance hemodialysis. Plasma tCa was inappropriately increased relative to iCa in 63% of the specimens; the iCa correlated with the PTH concentration in 12 of 19 pre-dialysis specimens, whereas tCa correlated with PTH in only five patients. During dialysis, 16 patients had analytically significant changes in iCa (i.e., exceeded the analytical imprecision of 0.04 mmol/L). Pre- and post-dialysis concentrations of PTH were normal in six patients, four of whom showed a detectable response to changes in iCa. Ten patients had increased PTH in at least one specimen; of these, eight had responsive parathyroid glands. Five of the 16 patients had an increased set point for calcium. The minimal PTH responses of two patients suggested refractory hyperparathyroidism. We conclude that routine estimation of iCa, rather than tCa, in dialysis patients markedly improves the identification of patients at risk for secondary hyperparathyroidism, and that measurement of intact PTH in pre- and post-dialysis serum offers a simple means of assessing parathyroid responsiveness in dialysis patients.

scholarly journals The influence of the progression of secondary hyperparathyroidism on the set point of the parathyroid hormone-calcium curve

2005 ◽  
Vol 184 (1) ◽  
pp. 241-247 ◽  
Author(s):  
S Bas ◽  
E Aguilera-Tejero ◽  
A Bas ◽  
J C Estepa ◽  
I Lopez ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Hemodialysis Patients ◽  
Calcium Receptor ◽  
Set Point ◽  
Group I ◽  
Complex Process ◽  
Two Stages ◽  
Early Phases

The influence of secondary hyperparathyroidism (2 HPT) on the set point of the parathyroid hormone (PTH)-Ca2+ curve is controversial. In vitro experiments have shown an increase in the set point. However, clinical studies with hemodialysis patients have provided a variety of results (increases, decreases and no changes in the set point have been reported). The present study was designed to investigate the influence of the progression of 2 HPT on the set point of the PTH-Ca2+ curve. The PTH-Ca2+ curve and the expression of parathyroid calcium receptor (CaR mRNA) and vitamin D receptor (VDR mRNA) have been studied in normal rabbits (group I, n=9) and in nephrectomized rabbits (group II, n=18) at two stages after inducing 2 HPT: 2–3 weeks (group IIA) and 5–6 weeks (group IIB). In group I, the set point of the PTH-Ca2+ curve was 1.63±0.03 mM. A progressive hypocalcemia was detected during the evolution of 2 HPT (groups IIA and IIB). Rabbits from group IIA had a significant (P<0.001) decrease in the set point to values of 1.45±0.02 mM. However, the set point increased significantly in group IIB (P<0.001) to 1.56±0.03 mM. CaR mRNA was similarly decreased in groups IIA (39±12%) and IIB (48±7%). No changes were detected in VDR mRNA. In conclusion, a reduction in the set point of the PTH-Ca2+ curve in response to decreased extracellular Ca2+ was detected in the early phases of 2 HPT. However, with the progression of 2 HPT the set point tended to increase even though extracellular Ca2+ was markedly decreased. The increase in the set point in the course of 2 HPT seems to be a complex process that cannot be fully explained by changes in parathyroid CaR mRNA or VDR mRNA.

scholarly journals The effect of long-term intravenous calcitriol administration on parathyroid function in hemodialysis patients.

1991 ◽  
Vol 2 (5) ◽  
pp. 1014-1020 ◽  
Author(s):  
M Rodriguez ◽  
A J Felsenfeld ◽  
C Williams ◽  
J A Pederson ◽  
F Llach
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Hemodialysis Patients ◽  
Parathyroid Cell ◽  
Dialysis Patients ◽  
Prolonged Administration ◽  
Set Point ◽  
Parathyroid Function ◽  
Before And After ◽  
Pth Level

Secondary hyperparathyroidism is common in dialysis patients. Intravenous calcitriol has proven to be an effective therapy for the reduction of parathyroid hormone (PTH) levels. However, the effect of i.v. calcitriol on parathyroid function, defined as the sigmoidal PTH-calcium curve developed during hypocalcemia and hypercalcemia, has not been evaluated during the prolonged administration of i.v. calcitriol. Six hemodialysis patients with marked secondary hyperparathyroidism, PTH levels greater than 500 pg/mL (normal, 10 to 65 pg/mL), were treated for 42 wk with 2 micrograms of i.v. calcitriol after each hemodialysis. Parathyroid function was evaluated before and after 10 and 42 wk of calcitriol therapy. Between baseline and 42 wk, the basal PTH level decreased from 890 +/- 107 to 346 +/- 119 pg/mL (P less than 0.02) and the maximally stimulated PTH level decreased from 1293 +/- 188 to 600 +/- 140 pg/mL (P less than 0.01). In addition, calcitriol administration significantly decreased PTH levels throughout the hypocalcemic range of the PTH-calcium curve. Although the slope of the PTH-calcium curve (with maximal PTH as 100%) decreased between baseline and 42 wk (P less than 0.05), the set point of calcium did not change. Two patients with a decrease in both basal and maximally stimulated PTH levels after 10 wk of calcitriol, developed marked hyperphosphatemia between 10 and 42 wk; this resulted in an exacerbation of hyperparathyroidism despite continued calcitriol therapy. In conclusion, prolonged i.v. calcitriol administration is an effective treatment for secondary hyperparathyroidism in hemodialysis patients provided that reasonable control of the serum phosphate is achieved. In addition, the slope of the PTH-calcium curve may be a better indicator of parathyroid cell sensitivity than the set point of calcium.

Effects of Long-Term Cinacalcet Administration on Parathyroid Gland in Hemodialysis Patients with Secondary Hyperparathyroidism

Nephron ◽  
2019 ◽  
Vol 142 (2) ◽  
pp. 106-113
Author(s):  
Senji Okuno ◽  
Masaaki Inaba ◽  
Eiji Ishimura ◽  
Shinya Nakatani ◽  
Hidenori Chou ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Hemodialysis Patients

Switch from calcitriol to paricalcitol in secondary hyperparathyroidism of hemodialysis patients: Responsiveness is related to parathyroid gland size

2011 ◽  
Vol 15 (1) ◽  
pp. 69-78 ◽  
Author(s):  
Carlo VULPIO ◽  
Giulia MARESCA ◽  
Enrico DISTASIO ◽  
Silvia CACACI ◽  
Nicola PANOCCHIA ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Hemodialysis Patients ◽  
Gland Size

Effects of 1,25-dihydroxy-22-oxavitamin D3 on parathyroid gland function in haemodialysis patients with secondary hyperparathyroidism

2002 ◽  
Vol 17 (suppl_10) ◽  
pp. 20-27 ◽  
Author(s):  
Eriko Kinugasa ◽  
Tadao Akizawa ◽  
Junko Takahashi ◽  
Kunihiro Nabeshima ◽  
Hiroaki Ogata ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Gland Function
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