Long-term intravenous calcitriol in secondary hyperparathyroidism: the role of technetium-99m-MIBI scintigraphy in predicting the response to treatment.

Abstract:

BACKGROUND:Despite the effectiveness of intravenous calcitriol in suppressing parathyroid hormone secretion in patients with uremic hyperparathyroidism, 50% of the patients remain refractory to this treatment. There are conflicting reports regarding the factors that can predict the response to treatment. Technetium-99m-MIBI scintigraphy was found to be correlated with functional activity of the parathyroid gland. METHODS:We, retrospectively, evaluated 16 chronic hemodialysis patients, who were maintained on i.v. calcitriol for 36 months or longer, and who had MIBI scan either at the start of, or within the first 6 months of starting calcitriol. Nine patients had a positive uptake (+ve group), and 7 patients had a negative uptake (-ve group). All patients had an elevated iPTH (iPTH > 300 pg/ml) at the start of treatment. RESULTS:The percentage reduction of iPTH in the (-ve) and the (+ve) groups was 65% versus 45% at 12 months, and 65% versus 10% at 36 months respectively. In long-term follow-up of 36 months, all the patients in the (-ve) group responded to calcitriol; while 8 of the 9 patients (89%) in the (+ve) group didn't respond. The difference in response between the 2 groups was statistically significant (p<0.001). CONCLUSION:We conclude that MIBI scan is a reliable technique in predicting the response to treatment with i.v. calcitriol in patients with secondary hyperparathyroidism.

journal_name

Ren Fail

journal_title

Renal failure

authors

Owda AK,Mousa D,Abdallah AH,Hawas FA,Al-Harbi W,Fedail H,At-Shoail G,Al-Sulaiman MH,Al-Khader AA

doi

10.1081/jdi-120004093

subject

Has Abstract

pub_date

2002-03-01 00:00:00

pages

165-73

issue

2

eissn

0886-022X

issn

1525-6049

journal_volume

24

pub_type

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