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Review paper

Significance of parathyroid scintigraphy and correlation of findings with parathyroid hormone values in patients undergoing hemodialysis

By
Nermana Ahmetbegović Orcid logo ,
Nermana Ahmetbegović
Contact Nermana Ahmetbegović

Department of Nuclear Medicine, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Nadira Suljagić ,
Nadira Suljagić

Department of Family Medicine, Public Health Institution Brčko, Brčko, Bosnia and Herzegovina

Vahidin Katica
Vahidin Katica

Clinic for Gynecology and Obstetrics, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina

Abstract

Aim
To compare finding of thyroid gland scintigraphy with serum concentration of parathyroid hormone in patients undergoing hemodialysis.
Methods
This retrospective-prospective study included 50 patients undergoing hemodialysis with established hyperparathyroidism who were treated at Cantonal Hospital Zenica in the period 2009-2014. Besides anthropological data, concentration of parathyroid hormone in serum of patients was monitored too. Scintigraphy was performed at the Department of Nuclear Medicine using two-headed gamma camera Prism 2000xp.
Results
Of the total number of 50 patients, 24 (48%) were males and 26 (52%) were females. The average age was 49.34±11.82 years. A total of 17 (34%) patients had normal findings of scintigraphy, 11 (22%) had mildly pronounced uptake of radiopharmaceuticals (score of 1), 14 (28%) had moderately pronounced uptake (score of 2), and eight (16%) had intensive uptake of radiopharmaceuticals (score of 3). A statistically significant difference was established in the length of hemodialysis treatment and scintigraphy finding (p=0.041).
Conclusion
Scintigraphy of parathyroid glands in patients undergoing hemodialysis allows us to select them for parathyroidectomy. Scintigraphy of parathyroid glands and a value of parathormone in serum should be incorporated into the test algorithm for patients with secondary hyperparathyroidism caused by chronic kidney disease.

References

1.
Ostojić L. Mineralno koštani poremećaji u hroničnoj bubrežnoj bolesti. Medicina Fluminensis. 2010. p. 463–70.
2.
Andress D, Coyne D, Kalantar-Zadeh K, Molitch M, Zangeneh F, Sprague S. Management of secondary hyperparathyroidism in stages 3 and 4 chronic kidney disease. Endocr Pract. 2008. p. 18–27.
3.
Mejia N, Garcia R, Miar P, Tavira A, B, Jb CA. Chronic kidney disease-mineral and bone disorder: a complex scenario. Nefrologia. 2011. p. 514–9.
4.
Orellana J, Esteban R, Castilla Y, Fernández-Castillo R, Nozal-Fernández G, Esteban M, et al. Use of cinacalcet for the management of hyperparathyroidism in patients with different degrees of renal failure. Nefrologia. 2016. p. 121–5.
5.
Egido J, Martínez-Castelao A, Bover J, Praga M, Torregrosa J, Fernández-Giráldez E, et al. The pleiotropic effects of paricalcitol: Beyond bone-mineral metabolism. Nefrologia. 2016. p. 10–8.
6.
Díaz-Guerra M, G, Iglesias G, S, Carranza H, F. Normocalcemic primary hyperparathyroidism: a growing problem. Med Clin (Barc). 2013. p. 125–9.
7.
Joy M, Karagiannis P, Peyerl F. Outcomes of secondary hyperparathyroidism in chronic kidney disease and the direct costs of treatment. J Manag Care Pharm. 2007. p. 397–411.
8.
Slinin Y, Foley R, Collins A. Calcium, phosphorus, parathyroid hormone, and cardiovascular disease in hemodialysis patients: the USRDS waves 1.3, and 4 study. J Am Soc Nephrol. 2005. p. 1788–93.
9.
Orlić L. Mineral and bone disorder in chronic kidney disease. Medicina Fluminensis. 2010. p. 463–70.
10.
Cordellat I. Hyperparathyroidism: primary or secondary disease? Reumatol Clin. 2012. p. 287–91.
11.
Moe S, Drüeke T, Cunningham J, Goodman W, Martin K, Olgaard K, et al. Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006. p. 1945–53.
12.
Nishitani H, Miki T, Morii H, Nishizawa Y, Ishimura E, Hagiwara S, et al. Decreased bone mineral density in diabetic patients on hemodialysis. Contrib. Nephrol. 1991. p. 223–7.
13.
Pei Y, Hercz G, Greenwood C, Segre G, Manuel A, Saiphoo C, et al. Renal osteodystrophy in diabetic patients. Kidney Int. 1993. p. 159–64.
14.
Eknoyan G, Lameire N, Barsoum R, Eckardt K, Levin L, Locatelli N, et al. The burden of kidney disease: improving global outcomes. Kidney Int. 2004. p. 1310–4.
15.
Palestro C, Tomas M, Tronco G. Radionuclide imaging of the parathyroid glands. Semin Nucl Med. 2005. p. 266–76.
16.
Díaz-Expósito R, Casáns-Tormo I, Cassinello-Fernández N, Ortega-Serrano J, Mut-Dólera T. Contribution of intraoperative scintigraphy to the detection of intrathyroidal parathyroid adenoma. Rev Esp Med Nucl Imagen Mol. 2014. p. 296–8.
17.
Lj D, Alcsio-Milidevid B, Antic M. Rezultati liječenja dijalizama u Srbiji: 10 godina kasnije. Monografije naučnih skupova. AMN SLD. 2010. p. 3.
18.
Chauhan V, Kelepouris E, Chauhan N, Vaid M. Current concepts and management strategies in chronic kidney disease-mineral and bone disorder. South Med J. 2012. p. 85.
19.
Martin K, Gonzales E. Metabolic bone disease in chronic kidney disease. J Am Soc Nephrol. 2007. p. 875–85.
20.
Russell C, Edis A. Surgery for primary hyperparathyroidism: experience with 500 consecutive cases and evaluation of the role of surgery in the asymptomatic patient. Br J Surg. 1982. p. 244–7.
21.
Echenique-Elizondo M, Díaz-Aguirregoitia F, Amondarain J, Vidaur F. Parathyroid graft function after presternal subcutaneous autotransplantation for renal hyperparathyroidism. Arch Surg. 2006. p. 33–8.
22.
Clark P. Parathyroid scintigraphy: optimizing preoperative localization. Appl Radiol. 2005. p. 24–8.
23.
Resić H, Selimović K, Kapidžić E, Kuka-Vican A, Šahović V, Mašnić F. Renalna osteodistrofija kod pacijenata na hemodijalizi. Medicinski žurnal. 2009. p. 106–10.
24.
Hadžibulić E, Birđozlić Š. Poremećaji mineral kostiju kod bolesnika na dijalizi u zdravstvenom centru Novi Pazar. Sanamed. 2010. p. 17–20.
25.
Kudamija M, Dits S, Hršak P, Mihovilović K, Pavlović D. Liječenje sekundarnog hiperparatireoidizma malim dozama sinakalceta i parikalcitolom. Acta Med Croatica. 2014. p. 34–8.
26.
Reihelm D, Šefers, Pavlović D. Parikalcitrol u liječenju sekundarnog hiperparatireoidizma u starijih osoba. Acta Med Croatica. 2014. p. 30–3.
27.
Kidneydisease. Improving Global Outcomes (KDI-GO) CKD-MBD Work Group. KDIGO Clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease -Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2009. p. 1–130.
28.
Akin M, Atasever T, Kurukahvecioglu O, Dogan M, Gokaslan D, Poyraz A, et al. Preoperative detection of parathyroid adenomas with Tc-99m MIBI and Tc-99m pertechnetate scintigraphy: histopathological and biochemical correlation with Tc-99m MIBI uptake. Bratisl Lek Listy. 2009. p. 166–9.
29.
Goodman W. The consequences of uncontrolled secondary hyperparathyroidism and its treatment in chronic kidney disease. Semin Dial. 2004. p. 209–16.

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