Nephrol Dial Transplant (1999) 14: 2574-2577
© 1999 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Selective percutaneous ethanol injection therapy (PEIT) of the parathyroid in chronic dialysis patients—the Japanese strategy
Japanese Working Group on PEIT of Parathyroid, Tokyo, Japan
Correspondence and offprint requests to: Masafumi Fukagawa, MD, PhD, Division of Nephrology and Clinical Research Center, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo 102-8798, Japan.
Introduction
High turnover bone disease due to excess parathyroid hormone (PTH) is one of the central features of bone abnormality in chronic dialysis patients [1]. Management of this type of uraemic bone disease has been aimed at the correction of the stimuli of PTH secretion. Thus, phosphate binders, in addition to dietary phosphorus restriction and oral active vitamin D sterols, have been used in most of these patients [2]. Among routinely available therapeutic modalities, calcitriol pulse therapy is considered to be the most potent medical therapy [3]. Nevertheless, some patients are even refractory to this therapy. Such patients usually have one or more enlarged parathyroid glands [4], and could be managed only by surgical parathyroidectomy until recently [5]. In this brief review, we would like to present a new approach to such patients which is currently becoming popular in Japan.
Parathyroid hyperplasia: pathophysiology and clinical significance
Recent
Principles of selective PEIT of parathyroid in uraemic patients
Future Directions
Acknowledgments
References
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