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Secondary hyperparathyroidism

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https://www.readbyqxmd.com/read/29161689/interactive-effectiveness-of-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-or-their-combination-on-survival-of-hemodialysis-patients
#1
Ryo Kido, Tadao Akizawa, Masafumi Fukagawa, Yoshihiro Onishi, Takuhiro Yamaguchi, Shunichi Fukuhara
BACKGROUND: Does the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers individually or as a combination confer a survival benefit in hemodialysis patients? The answer to this question is yet unclear. METHODS: We performed a case-cohort study using data from the Mineral and Bone Disorder Outcomes Study for Japanese CKD stage 5D patients (MBD-5D), a 3-year multicenter prospective case-cohort study, including 8,229 hemodialysis patients registered from 86 facilities in Japan...
November 21, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29160114/complex-spinal-fixation-of-a-cervical-vertebra-brown-tumour-report-of-an-unusual-case
#2
Sebastian Miguel Toescu, Maria Ibrahim, Dominic G O'Donovan, Gowrie Balasubramaniam, Karoly M David
Brown tumours affecting the cervical spine are a rare but recognised complication of renal failure-related secondary hyperparathyroidism. We present a case of a 26 year-old female with radiculopathy who was managed successfully with 360° cervical spine fixation and parathyroidectomy.
November 21, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29156056/high-doses-of-cholecalciferol-alleviate-the-progression-of-hyperparathyroidism-in-patients-with-ckd-stages-3-4-results-of-a-12-week-double-blind-randomized-controlled-study
#3
Per-Anton Westerberg, Gunnar Sterner, Östen Ljunggren, Elin Isaksson, Fjölnir Elvarson, Hamid Dezfoolian, Torbjörn Linde
Background: Calcidiol insufficiency may accelerate the development of secondary hyperparathyroidism (SHPT). We tested the effect of a substantial increase in calcidiol on mineral metabolism in patients with chronic kidney disease (CKD). Methods: Ninety-five patients with CKD Stages 3-4, parathyroid hormone (PTH) above 6.8 pmol/L and calcidiol below 75 nmol/L were randomized to receive either cholecalciferol 8000 IU/day or placebo for 12 weeks. The primary endpoint was difference in the mean change in iPTH after 12 weeks...
May 30, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29154082/are-preoperative-sestamibi-scans-useful-for-identifying-ectopic-parathyroid-glands-in-patients-with-expected-multigland-parathyroid-disease
#4
Farah Karipineni, Zeyad Sahli, Helina Somervell, Aarti Mathur, Jason D Prescott, Ralph P Tufano, Martha A Zeiger
BACKGROUND: The role of preoperative localization studies in patients with hyperparathyroidism and expected multigland disease remains poorly defined. Our study investigates the usefulness of obtaining preoperative sestamibi scans and ultrasonography of the neck in identifying ectopic glands in this group of patients. METHODS: Under Institutional Review Board approval, we performed a retrospective review of patients who underwent operation for secondary hyperparathyroidism, tertiary hyperparathyroidism, lithium-induced hyperparathyroidism, and multiple endocrine neoplasia syndrome at a tertiary institution between 2004 and 2015...
November 16, 2017: Surgery
https://www.readbyqxmd.com/read/29146232/parathyroidectomy-in-patients-with-chronic-kidney-disease-impacts-of-different-techniques-on-the-biochemical-and-clinical-evolution-of-secondary-hyperparathyroidism
#5
Roxana de Fátima Camelo Albuquerque, Cinthia Esbrile Moraes Carbonara, Rita de Cássia T Martin, Luciene Machado Dos Reis, Climério Pereira do Nascimento, Sérgio Samir Arap, Rosa M A Moysés, Vanda Jorgetti, Fábio L M Montenegro, Rodrigo Bueno de Oliveira
BACKGROUND: Parathyroidectomy (PTx) decreases the mortality rate of refractory secondary hyperparathyroidism (rSHP) due to chronic kidney disease. A consensus regarding which techniques of PTx are associated with better outcomes is not available. The aims of this study are to evaluate the clinical and laboratory evolution of 49 hemodialysis patients with rSHP who underwent PTx using different techniques. METHODS: Patients underwent subtotal PTx (sub-PTx) or total PTx with autotransplantation (AT) of 45 (PTx-AT45) or 90 parathyroid fragments (PTx-AT90) and were followed for 12 months...
November 13, 2017: Surgery
https://www.readbyqxmd.com/read/29143130/two-threshold-levels-of-vitamin-d-and-the-prevalence-of-comorbidities-in-outpatients-of-a-tertiary-hospital
#6
I N Furuie, M J J Mauro, S Petruzziello, S C Riechi, R R Petterle, C L Boguszewski, V Z C Borba
This study evaluated the number of comorbidities between two normal values of 25OHD in outpatients during 1 year of 25OHD measurements. Five hundred twenty-nine outpatients were included, patients with 25OHD ≥ 20 and < 30 ng/mL had the higher number of comorbidities, suggesting that for this specific population, 25OHD ≥ 30 ng/mL would be more appropriate. INTRODUCTION : This study evaluated the comorbidities between two values of 25OHD in outpatients of a tertiary hospital. METHODS: This is a cross-sectional study with measures of 25OHD in 1-year period, excluding 25OHD < 20 and > 50 ng/mL, clinical research participants, and liver disease and chronic renal failure patients...
November 15, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29142982/a-single-and-multiple-dose-multicenter-study-of-etelcalcetide-in-japanese-hemodialysis-patients-with-secondary-hyperparathyroidism
#7
Keitaro Yokoyama, Masafumi Fukagawa, Takashi Shigematsu, Takashi Akiba, Akifumi Fujii, Akinori Yamauchi, Motoi Odani, Tadao Akizawa
Introduction: The pharmacokinetics, pharmacodynamics, and safety and tolerability profile of etelcalcetide (ONO-5163/AMG 416), a novel, i.v., long-acting calcium-sensing receptor agonist, were studied in Japanese hemodialysis patients with secondary hyperparathyroidism. Methods: This multicenter, randomized, double-blind, placebo-controlled, parallel-group study consisted of a single dose part and a multiple dose (3 times weekly for 4 weeks) part. Major inclusion criteria were hemodialysis for at least 90 days, serum intact parathyroid hormone (iPTH) ≥ 300 pg/ml, and serum albumin-corrected Ca (cCa) ≥ 9...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29134448/hyperammonemia-associated-with-distal-renal-tubular-acidosis-or-urinary-tract-infection-a-systematic-review
#8
Caterina M Clericetti, Gregorio P Milani, Sebastiano A G Lava, Mario G Bianchetti, Giacomo D Simonetti, Olivier Giannini
BACKGROUND: Hyperammonemia usually results from an inborn error of metabolism or from an advanced liver disease. Individual case reports suggest that both distal renal tubular acidosis and urinary tract infection may also result in hyperammonemia. METHODS: A systematic review of the literature on hyperammonemia secondary to distal renal tubular acidosis and urinary tract infection was conducted. RESULTS: We identified 39 reports on distal renal tubular acidosis or urinary tract infections in association with hyperammonemia published between 1980 and 2017...
November 13, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29134242/serum-parathyroid-hormone-is-associated-with-increased-cortical-porosity-of-the-inner-transitional-zone-at-the-proximal-femur-in-postmenopausal-women-the-troms%C3%A3-study
#9
M Osima, T T Borgen, M Lukic, G Grimnes, R M Joakimsen, E F Eriksen, Å Bjørnerem
Serum parathyroid hormone (PTH) was associated with increased bone turnover markers and cortical porosity of the inner transitional zone at the proximal femur. These results suggest that PTH through increased intracortical bone turnover leads to trabecularisation of inner cortical bone in postmenopausal women. INTRODUCTION: Vitamin D deficiency leads to secondary hyperparathyroidism and increased risk for fractures, whereas its association with cortical porosity is less clear. We tested (i) whether serum 25-hydroxyvitamin D (25(OH)D) and PTH were associated with cortical porosity and (ii) whether the associations of 25(OH)D) and PTH with fracture risk are dependent on cortical porosity...
November 14, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29131092/value-of-intraoperative-parathyroid-hormone-assay-during-parathyroidectomy-in-dialysis-and-renal-transplant-patients-with-secondary-and-tertiary-hyperparathyroidism
#10
Amr El-Husseini, Kevin Wang, Annick Edon, David Saxon, Florence Lima, David Sloan, B Peter Sawaya
BACKGROUND: In dialysis and renal transplant patients with secondary and tertiary hyperparathyroidism (HPT), the value of intraoperative parathyroid hormone (ioPTH) during parathyroidectomy (PTX) and its association with long-term PTH levels are unknown. The present study aims at evaluating the relationship of ioPTH with long-term PTH levels post-PTX in dialysis and renal transplant patients in a single-center study. METHODS: The ioPTH was measured in 57 dialysis patients (33 females and 24 males) and 18 renal transplant recipients (12 males and 6 females) who underwent PTX from 2005 to 2015 for refractory HPT...
November 9, 2017: Nephron
https://www.readbyqxmd.com/read/29124559/hungry-bone-syndrome-two-weeks-after-starting-cinacalcet-a-call-for-caution
#11
Sahar H Koubar, Abd Assalam Qannus, Walid Medawar, Ali K Abu-Alfa
Cinacalcet is an effective and safe alternative to parathyroidectomy in end stage renal disease (ESRD) patients with secondary hyperparathyroidism. Hypocalcemia is a known complication of treatment that is usually readily reversible upon discontinuation of the drug. It rarely manifests severely and symptomatically requiring hospital admission. We present the case of a 55 year old man with severe, symptomatic and prolonged hypocalcemia that occurred 2 weeks after starting cinacalcet. Cinacalcet induced a state of pharmacological parathyroidectomy with subsequent hungry bone syndrome...
November 9, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29108515/long-term-use-of-cinacalcet-in-kidney-transplant-recipients-with-hypercalcemic-secondary-hyperparathyroidism-a-single-center-prospective-study
#12
Vasileios Zavvos, Lamprini Fyssa, Marios Papasotiriou, Evangelos Papachristou, Theodoros Ntrinias, Eirini Savvidaki, Dimitrios S Goumenos
OBJECTIVES: Persistent secondary hyperparathyroidism is common after successful kidney transplant, with concomitant hypercalcemia and hypophosphatemia potentially leading to reduced graft survival and increased cardiovascular risk. Cinacalcet, a calcimimetic agent that activates the calcium-sensing receptors in parathyroid glands, is a therapeutic option. In this study, we assessed the long-term treatment effects of cinacalcet for a period of up to 5 years in a cohort of kidney transplant recipients...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29107998/impact-of-surgical-parathyroidectomy-on-chronic-kidney-disease-mineral-and-bone-disorder-ckd-mbd-a-systematic-review-and-meta-analysis
#13
Mugurel Apetrii, David Goldsmith, Ionut Nistor, Dimitrie Siriopol, Luminita Voroneanu, Dragos Scripcariu, Marc Vervloet, Adrian Covic
For more than 6 decades, many patients with advanced chronic kidney disease (CKD) have undergone surgical parathyroidectomy (sPTX) for severe secondary hyperparathyroidism (SHPT) mainly based historical clinical practice patterns, but not on evidence of outcome.We aimed in this meta-analysis to evaluate the benefits and harms of sPTX in patients with SHPT. We searched MEDLINE (inception to October 2016), EMBASE and Cochrane Library (through Issue 10 of 12, October 2016) and website clinicaltrials.gov (October 2016) without language restriction...
2017: PloS One
https://www.readbyqxmd.com/read/29093248/-effect-of-cinacalcet-combined-with-low-dose-calcitriol-on-clinical-outcome-and-bone-metabolism-in-patients-with-severe-secondary-hyperparathyroidism
#14
Fang Yuan, Xing Chen, Chang Wang, An Zhou, Hong Liu
To observe the clinical outcome and the effect of the combination of cinacalcet hydrochloride with low-dose calcitriol on bone metabolism in maintenance hemodialysis (MHD) patients with severe secondary hyperparathyroidism (SHPT).
 Methods: Thirty SHPT patients were enrolled to receive treatment of cinacalcet combined with low-dose calcitriol, with inclusion criteria as follows: maintenance on MHD>6 months; serum intact parathyroid hormone (iPTH)>600 pg/mL; parathyroid glands with more than 1 nodules by ultrasonography; traditional therapy with no effects...
October 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29083339/reoperation-for-persistent-or-recurrent-secondary-hyperparathyroidism
#15
Alida Abruzzo, Maria Concetta Gioviale, Giuseppe Damiano, Vincenzo Davide Palumbo, Salvatore Buscemi, Giulia Lo Monte, Leonardo Gulotta, Giuseppe Buscemi, Attilio Ignazio Lo Monte
BACKGROUND: Secondary hyperparathyroidism is a common acquired disorder seen in chronic renal failure. Its pathophysiology is mainly due to hyperphosphatemia and vitamin D deficiency and resistance. When medical treatment fails, subtotal and total parathyroidectomy with autotransplantation are the standard procedures, although both are associated with high recurrence rates. METHODS AND RESULTS: 4 patients experienced persistence and 9 relapse. The first 4 were subjected to reoperation after 6 months for the persistence of symptoms due to the finding of a supernumerary adenomatous gland while the remaining patients at the reoperation showed in 5 cases 2 more glands in over thymic position, and 4 an hyperplasia of the residual glandular tissue...
October 23, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29078836/secondary-hyperparathyroidism-in-heart-failure
#16
REVIEW
Mohamed S Morsy, Dwight A Dishmon, Nadish Garg, Karl T Weber
Secondary hyperparathyroidism (SHPT) is a well-known pathophysiologic feature of chronic renal failure. In recent years, SHPT has become recognized as a complication of the aldosteronism associated with congestive heart failure and where excretory Ca(2+) and Mg(2+) wasting results in plasma-ionized hypocalcemia and hypomagnesemia. Elevations in plasma parathyroid hormone have adverse systemic consequences, including intracellular Ca(2+) overloading of myocytes and vascular smooth muscle with the induction of oxidative stress...
October 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29074835/-update-on-recent-progress-in-vitamin-d-research-treatment-of-metabolic-bone-disorders-by-vitamin-d
#17
Reiko Watanabe, Daisuke Inoue
Vitamin D is indispensable for bone health and calcium metabolism, and decreased action of vitamin D causes various abnormalities in bone metabolism. Severe vitamin D deficiency causes osteomalacia/rickets. Even milder vitamin D insufficiency could still be harmful for bone health via secondary hyperparathyroidism and bone loss, and could also lead to increased risk of falling. Osteomalacia/rickets associated with impaired vitamin D action should be treated by either native or active vitamin D3, depending on its etiology...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/29074834/-update-on-recent-progress-in-vitamin-d-research-the-role-of-vitamin-d-in-management-of-ckd-mbd
#18
Naoto Hamano, Masafumi Fukagawa
Vitamin D was originally discovered as a substance which alleviates rickets and studies revealed that vitamin D exerts pleiotropic effects. Vitamin D has a therapeutic effect on Chronic Kidney Disease(CKD)-associated bone lesion or secondary hyperparathyroidism. On the other hand, excessive vitamin D induces calcium and phosphate overload, resulting in vascular calcification and cardiovascular events. From the data so far, not all CKD patients can get the benefit of vitamin D. It is well indicated for CKD patients with vitamin D insufficiency, secondary parathyroidism, hypocalcemia, or low-turnover bone disease on the basis of avoiding calcium over load...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/29074833/-update-on-recent-progress-in-vitamin-d-research-vitamin-d-insufficiency-deficiency
#19
Ryo Okazaki
Serum 25(OH)D level reflects bodily vitamin D store. Recently published "Assessment criteria for vitamin D deficiency/insufficiency in Japan" defines vitamin D sufficiency as 25(OH)D level of 30 ng/mL or more, vitamin D insufficiency as that of 20 to 30 ng/mL, vitamin D deficiency as that of less than 20 ng/mL. The lower the serum 25(OH)D level is, the higher the risks are, of secondary hyperparathyroidism, low bone mineral density, fall, fracture, rickets/osteomalacia, and hypocalcemia, as well as lower response to anti-osteoporosis medications...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/29072378/-primary-and-secondary-hyperparathyroidism-presenting-as-brown-tumor
#20
Avraham Toeg, Victoria Yaffe-Gartsbein, Omri Emodi, Imad Abu El-Naaj
Hyperparathyroidism (HPT) may lead to the formation of osteolytic lesions with giant granulomas. Giant cell lesions associated with HPT are known as brown tumor and represent an end stage complication of HPT. Brown tumors affect the mandible, clavicles, ribs and pelvis. Maxillary involvement is rare. We present two cases of brown tumor: the first is a case of primary HPT involving the maxilla and the second case is secondary HPT involving the mandible. Differential diagnosis, work up and methods of management of the jaw lesions are discussed...
October 2017: Harefuah
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