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.
Ostojić L. Mineralno koštani poremećaji u hroničnoj bubrežnoj bolesti. Medicina Fluminensis. 2010;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;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;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;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;10–8.
6.
Díaz-Guerra M, G, Iglesias G, S, Carranza H, F. Normocalcemic primary hyperparathyroidism: a growing problem. Med Clin (Barc). 2013;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;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;1788–93.
9.
Orlić L. Mineral and bone disorder in chronic kidney disease. Medicina Fluminensis. 2010;463–70.
10.
Cordellat I. Hyperparathyroidism: primary or secondary disease? Reumatol Clin. 2012;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;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;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;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;1310–4.
15.
Palestro C, Tomas M, Tronco G. Radionuclide imaging of the parathyroid glands. Semin Nucl Med. 2005;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;296–8.
17.
Lj D, Alcsio-Milidevid B, Antic M. Rezultati liječenja dijalizama u Srbiji: 10 godina kasnije. Monografije naučnih skupova. AMN SLD. 2010;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;85.
19.
Martin K, Gonzales E. Metabolic bone disease in chronic kidney disease. J Am Soc Nephrol. 2007;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;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;33–8.
22.
Clark P. Parathyroid scintigraphy: optimizing preoperative localization. Appl Radiol. 2005;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;106–10.
24.
Hadžibulić E, Birđozlić Š. Poremećaji mineral kostiju kod bolesnika na dijalizi u zdravstvenom centru Novi Pazar. Sanamed. 2010;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;34–8.
26.
Reihelm D, Šefers, Pavlović D. Parikalcitrol u liječenju sekundarnog hiperparatireoidizma u starijih osoba. Acta Med Croatica. 2014;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;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;166–9.
29.
Goodman W. The consequences of uncontrolled secondary hyperparathyroidism and its treatment in chronic kidney disease. Semin Dial. 2004;209–16.
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