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.
Palestro C, Tomas M, Tronco G. Radionuclide imaging of the parathyroid glands. Semin Nucl Med 2005:266–76.
2
Goodman W. The consequences of uncontrolled secondary hyperparathyroidism and its treatment in chronic kidney disease. Semin Dial 2004:209–16.
3
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 2009:166–9.
4
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 2009:1–130.
5
Reihelm D, Šefers, Pavlović D. Parikalcitrol u liječenju sekundarnog hiperparatireoidizma u starijih osoba. Acta Med Croatica 2014:30–3.
6
Kudamija M, Dits S, Hršak P, Mihovilović K, Pavlović D. Liječenje sekundarnog hiperparatireoidizma malim dozama sinakalceta i parikalcitolom. Acta Med Croatica 2014:34–8.
7
Hadžibulić E, Birđozlić Š. Poremećaji mineral kostiju kod bolesnika na dijalizi u zdravstvenom centru Novi Pazar. Sanamed 2010:17–20.
8
Resić H, Selimović K, Kapidžić E, Kuka-Vican A, Šahović V, Mašnić F. Renalna osteodistrofija kod pacijenata na hemodijalizi. Medicinski Žurnal 2009:106–10.
9
Clark P. Parathyroid scintigraphy: optimizing preoperative localization. Appl Radiol 2005:24–8.
10
Echenique-Elizondo M, Díaz-Aguirregoitia F, Amondarain J, Vidaur F. Parathyroid graft function after presternal subcutaneous autotransplantation for renal hyperparathyroidism. Arch Surg 2006:33–8.
11
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 1982:244–7.
12
Martin K, Gonzales E. Metabolic bone disease in chronic kidney disease. J Am Soc Nephrol 2007:875–85.
13
Chauhan V, Kelepouris E, Chauhan N, Vaid M. Current concepts and management strategies in chronic kidney disease-mineral and bone disorder. South Med J 2012:85.
14
Lj D, Alcsio-Milidevid B, Antic M. Rezultati liječenja dijalizama u Srbiji: 10 godina kasnije. Monografije naučnih skupova. AMN SLD 2010:3.
15
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 2014:296–8.
16
Ostojić L. Mineralno koštani poremećaji u hroničnoj bubrežnoj bolesti. Medicina Fluminensis 2010:463–70.
17
Eknoyan G, Lameire N, Barsoum R, Eckardt K, Levin L, Locatelli N, et al. The burden of kidney disease: improving global outcomes. Kidney Int 2004:1310–4.
18
Pei Y, Hercz G, Greenwood C, Segre G, Manuel A, Saiphoo C, et al. Renal osteodystrophy in diabetic patients. Kidney Int 1993:159–64.
19
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 1991:223–7.
20
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 2006:1945–53.
21
Cordellat I. Hyperparathyroidism: primary or secondary disease? Reumatol Clin 2012:287–91.
22
Orlić L. Mineral and bone disorder in chronic kidney disease. Medicina Fluminensis 2010:463–70.
23
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 2005:1788–93.
24
Joy M, Karagiannis P, Peyerl F. Outcomes of secondary hyperparathyroidism in chronic kidney disease and the direct costs of treatment. J Manag Care Pharm 2007:397–411.
25
Díaz-Guerra M, G, Iglesias G, S, Carranza H, F. Normocalcemic primary hyperparathyroidism: a growing problem. Med Clin (Barc) 2013:125–9.
26
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 2016:10–8.
27
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 2016:121–5.
28
Mejia N, Garcia R, Miar P, Tavira A, B, Jb C-A. Chronic kidney disease-mineral and bone disorder: a complex scenario. Nefrologia 2011:514–9.
29
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 2008:18–27.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
