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Nephrol Dial Transplant (2003) 18: III53-III57
© 2003 European Renal Association-European Dialysis and Transplant Association

Original Article

Time course of change in calcium x phosphorus product after percutaneous ethanol injection therapy

Fumihiko Koiwa, Takeshi Hasegawa, Ichiro Kojima and Terukuni Ideura

Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan

Background. Percutaneous ethanol injection therapy (PEIT) effectively suppresses PTH secretion, but the change in the serum calcium and phosphorus product (CaxP) after PEIT has not been fully evaluated.

Methods. Twenty-seven haemodialysis patients with severe secondary hyperparathyroidism (2HPT) were divided into two groups according to their intact PTH (i-PTH) concentrations 6 months after PEIT: (i) effective (E) group, i-PTH concentration <360 pg/ml; and (ii) non-effective (N) group i-PTH ß360 pg/ml. The changes in serum calcium and phosphorus concentrations and the CaxP were recorded for the following 2 years under post-PEIT medical treatment with oral calcitriol or intravenous 22-oxacalcitriol (OCT).

Result. In the E group, the i-PTH concentrations decreased to <300 pg/ml 1 year after PEIT (801±302 to 280±134 pg/ml), then increased to 435±201 pg/ml at 2 years. Serum calcium concentration did not show any significant change except for a transient reduction at 1 month after PEIT. The CaxP decreased for 1 year (from 66.3±15.3 to 56.2±10.3 mg2/dl2; P<0.05), in agreement with the course of phosphorus concentration, and continued to be <60 mg2/dl2 up to 2 years after PEIT. The CaxP tended to decrease more with OCT than oral calcitriol. In the N group, calcium and CaxP increased significantly at 6 months after PEIT and remained at a high value.

Conclusion. Treatment with PEIT suppresses serum PTH concentration as well as CaxP in the long term.

Keywords: calcium and phosphorus product; ectopic calcification; hypercalcaemia; hyperphosphataemia; percutaneous ethanol injection therapy (PEIT); secondary hyperparathyroidism

Correspondence and offprint requests to: Fumihiko Koiwa, Showa University Fujigaoka Hospital, Division of Nephrology, Department of Internal Medicine 1-30 Fujigaoka, Aoba-ku, Yokohama 227-8501, Japan. Email: f-koiwa{at}sa2.so-net.ne.jp


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 NDT PlusHome page
F. Koiwa, T. Hasegawa, R. Tanaka, and T. Kakuta
Indication and efficacy of PEIT in the management of secondary hyperparathyroidism
NDT Plus, August 1, 2008; 1(suppl_3): iii14 - iii17.
[Abstract] [Full Text] [PDF]


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