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Nephrol Dial Transplant (2003) 18: III76-III78
© 2003 European Renal Association-European Dialysis and Transplant Association

Original Article

Combined radioguided parathyroidectomy and intravenous vitamin D therapy for the treatment of uraemic hyperparathyroidism

Yuko Oyama1, J. James Kazama1,2,, Hiroki Maruyama1, Ichiei Narita1, Chizuko Kanbayashi3, Yu Koyama3, Tsukasa Omori4, Katsuyoshi Hatakeyama3 and Fumitake Gejyo1

1 Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 2 Division of Intensive Care Medicine, Niigata University Medical Hospital, 3 Division of General Surgery, Niigata University Graduate School of Medical and Dental Sciences and 4 Omori Medical Clinic, Japan

Therapy combining radioguided parathyroidectomy (PTx) followed by intravenous maxacalcitol was given to a 50-year-old Japanese man referred for treatment of uraemic secondary hyperparathyroidism. After laboratory and radiological examinations, the patient underwent uncomplicated, successful surgery, but glands that had not been detected radiologically before the procedure became apparent with a scintillation counter immediately after the removal of the swollen gland. To prevent relapse of secondary hyperparathyroidism in the remaining glands, 10 µg of maxacalcitol was injected intravenously after each dialysis session. Following a minimally invasive radioisotope-guided PTx, the potential risk of relapse in the remaining glands has to be considered and intensive medical therapy should be instituted immediately after the operation. Further study needs to elucidate whether this treatment strategy can improve the long-term prognosis of patients with secondary hyperparathyroidism

Keywords: maxacalcitol; radioisotope-guided parathyroidectomy; secondary hyperparathyroidism

Correspondence and offprint requests to: Junichiro James Kazama MD, PhD, Niigata University Medical Hospital, 1-754 Asahimachi-Dori, Niigata, Niigata 951-8510, Japan. Email: jjkaz{at}med.niigata-u.ac.jp


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