Study data illustrate the potential benefits of controlling serum phosphate, intact parathyroid hormone, and calcium levels in patients with nondialysis-dependent chronic kidney disease.
In a large US study, only half of patients with stage 3, 4, and 5 had undergone PTH retesting at 12, 8, and 4.5 months, respectively, after treatment with vitamin D sterols, in line with KDIGO guidelines.
In a study of patients on dialysis, those treated with parathyroidectomy instead of cinacalcet had a lower risk of developing tertiary hyperparathyroidism.
Nutritional vitamin D supplements are frequently used to treat secondary hyperparathyroidism, especially in early chronic kidney disease, but they do not substantially lower parathyroid hormone levels, according to a meta-analysis.
Parathyroidectomy prior to kidney transplantation is associated with a lower risk for severe postoperative complications compared with calcimimetic treatment, according to investigators.
Patients undergoing parathyroidectomy for SHPT that is refractory to calcimimetics frequently show significant enlargement of the parathyroid glands as well as histopathologic alterations, new findings suggest.
