Is the volume of the parathyroid gland a predictor of Maxacalcitol response in advanced secondary hyperparathyroidism?

Abstract

We evaluated the relationship between the volume of parathyroid glands estimated by ultrasonography (US) and response of 22-oxa calcitriol (Maxacalcitol, OCT) in patients with secondary hyperparathyroidism (2HPT) to evaluate whether the volume can be a predictor of the OCT response. Eleven institutes participated in this study. Ninety-four patients with advanced 2HPT were enrolled. The volume of the parathyroid glands were estimated by US before and 6 months after OCT treatment. The response of OCT treatment was classified into three groups (Group A: i-PTH < 300 pg/mL; Group B: 300 pg/mL < or = i-PTH < 500 pg/mL; Group C: i-PTH > or = 500 pg/mL). Forty-eight patients were in Group A, 28 patients in Group B, and 18 patients in Group C. The PTH levels at the beginning and 6 months were 458.3-199.1 pg/mL (P < 0.0001) in Group A, 524.6-403.2 pg/mL (P = 0.007) in Group B and 736.7-613.6 pg/mL (ns) in Group C, respectively. The volume of the largest gland in Group B was significantly larger than that in Group A (96.2 vs. 343.2 mm3: P < 0.001). Clinical factors affecting response of OCT was evaluated by logistic regression analysis and only the volume of the largest gland was a significant factor. In the patients whose volume was less than 300 mm3, the OCT response was significantly effective. We conclude that the glandular volume of the largest parathyroid gland estimated by US can be a useful factor to predict the OCT response in patients with moderate or severe renal HPT.

• Authors: Yoshihiro Tominaga, Daijyo Inaguma, Susumu Matsuoka, Hideki Tahara, Kazutaka Kukita, Satoshi Kurihara, Noritaka Onoda, Yoshinari Tsuruta, Syuichi Tsutsui, Kazumichi Ohta, Morimasa Kuwahara, Motoko Tanaka, Yoshiki Nishizawa, PTG study group
• Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy (Ther Apher Dial) Vol. 10 Issue 2 Pg. 198-204 (Apr 2006) ISSN: 1744-9979 [Print] Australia
• PMID: 16684224 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Calcitriol
• maxacalcitol

Topics

• Calcitriol (analogs & derivatives, therapeutic use)
• Chi-Square Distribution
• Female
• Humans
• Hyperparathyroidism, Secondary (drug therapy, pathology)
• Male
• Middle Aged
• Parathyroid Glands (diagnostic imaging, drug effects)
• Renal Dialysis
• Statistics, Nonparametric
• Treatment Outcome
• Ultrasonography