Secondary Hyperparathyroidism News Archive

Cinacalcet Withdrawal Linked With PTH, Calcium Rise

Cinacalcet Withdrawal Linked With PTH, Calcium Rise

Serum parathyroid hormone levels significantly increased from 42.2 to 114.8 pmol/L over 12 months in patients who halted the calcimimetic drug.

Post-Parathyroidectomy Hypocalcemia Risk Factors Identified

Post-Parathyroidectomy Hypocalcemia Risk Factors Identified

Pre-operative parathyroid hormone and calcium levels and pruritus are significantly associated with development of severe hypocalemia.

Reducing PTH Might Improve Anemia in Hemodialysis

Reducing PTH Might Improve Anemia in Hemodialysis

Anemia control may be one more reason to treat elevated parathyroid hormone levels.

Post-Parathyroidectomy Predictors of Hungry Bone Syndrome Identified

Post-Parathyroidectomy Predictors of Hungry Bone Syndrome Identified

Predictors of hungry bone syndrome after parathyroidectomy include lower pre- and post-op calcium levels, according to a new study.

Cinacalcet Administration After Hemodialysis Safe, Effective

Cinacalcet Administration After Hemodialysis Safe, Effective

Control of parathyroid hormone did not differ markedly at 48 and 72 hours after in-center HD compared with 24 hours after daily oral administration of 30 mg cinacalcet.

Extended-Release Calcifediol Reduces Bone Turnover in SHPT

Extended-Release Calcifediol Reduces Bone Turnover in SHPT

Levels of the bone turnover markers CTX and P1NP declined over approximately 6 months of treatment patients with CKD and secondary hyperparathyroidism.

Vitamin D3 and D2 Similarly Effective for SHPT in CKD

Vitamin D3 and D2 Similarly Effective for SHPT in CKD

Researchers found no significant difference between ergocalciferol and cholecalciferol in maintaining levels of vitamin D, parathyroid hormone, and calcium.

Parathyroidectomy Reasonable for Refractory SHPT

Parathyroidectomy Reasonable for Refractory SHPT

The authors of a new review suggest more dialysis patients could benefit from parathyroidectomy.

Intensive Phosphorus-Lowering May Reduce PTH

Intensive Phosphorus-Lowering May Reduce PTH

In a study, intact parathyroid hormone levels fell by nearly 10% over 6 months in hemodialysis patients who received intensive treatment for hyperphosphatemia.

CKD-MBD Guideline Synopsis Issued

CKD-MBD Guideline Synopsis Issued

Panel focuses on diagnosing and testing of CKD-MBD and treatment of the CKD-MBD that emphasizes decreasing phosphate, maintaining calcium, and addressing elevated PTH in adults with CKD stage G3a to G5.

Coronary Artery Calcification Risk Factors in CKD Identified

Coronary Artery Calcification Risk Factors in CKD Identified

Abnormal calcium-phosphate metabolism appears to be an important pathogenic factor in the development of vascular calcification in patients with chronic kidney disease.

Calciphylaxis in CKD Patients Linked to Hypercoagulable Conditions

Calciphylaxis in CKD Patients Linked to Hypercoagulable Conditions

In patients with stage 5 chronic kidney disease, lupus anticoagulant and combined thrombophilia occur more frequently in those with versus without calciphylaxis, case-control study shows.

SHPT May Predict Left Ventricular Diastolic Dysfunction

SHPT May Predict Left Ventricular Diastolic Dysfunction

iPTH significantly correlated with measures of diastolic dysfunction in patients with non-dialysis chronic kidney disease.

Post-Parathyroidectomy Calcium Requirement Linked to Preop ALP

Post-Parathyroidectomy Calcium Requirement Linked to Preop ALP

Patients with high alkaline phosphatase prior to PTx should be treated aggressively after surgery to prevent postoperative hypocalcemia, researchers conclude.

PTH After Parathyroidectomy Indicates 5-Year PTH Outcomes

PTH After Parathyroidectomy Indicates 5-Year PTH Outcomes

In 2 studies, parathyroid hormone (PTH) values 20 minutes after parathyroidectomy predicted PTH levels for 5 years.

High, Low Values of CKD-MBD Markers Linked With Mortality

High, Low Values of CKD-MBD Markers Linked With Mortality

In a study, intact parathyroid hormone levels below 60 and above 1500 pg/mL were associated with nearly double the risk of all-cause mortality.

Ethanol Ablation Therapy Feasible for SHPT

Ethanol Ablation Therapy Feasible for SHPT

In a small study, more than half of patients with secondary hyperparathyroidism had a greater than 25% drop in parathyroid hormone levels following ethanol injection therapy.

SHPT Highly Prevalent Among Diabetic Nephropathy Patients

SHPT Highly Prevalent Among Diabetic Nephropathy Patients

Nearly 86% of diabetic nephropathy patients from an Egyptian outpatient center had elevated iPTH levels.

Hypocalcemia Common After Cinacalcet Initiation

Hypocalcemia Common After Cinacalcet Initiation

Hypocalcemia developed in 58.3% of study participants within the first 16 weeks and, in most cases, resolved within 14 days with no changes in treatment.

Parathyroidectomy for SHPT Improves Quality of Life

Parathyroidectomy for SHPT Improves Quality of Life

Patients reported less skin itching, joint pain, and muscle weakness after surgery.

Parathyroidectomy May Improve SHPT Patient Survival

Parathyroidectomy May Improve SHPT Patient Survival

ESRD patients with SHPT undergoing surgery had a 26% lower risk for all-cause mortality compared with medical management.

Elevated PTH Tied to Arteriovenous Fistula Maturation Failure

Elevated PTH Tied to Arteriovenous Fistula Maturation Failure

Secondary hyperparathyroidism may have a detrimental effect on successful arteriovenous fistula creation, researcher says.

Etelcalcetide Injection Into Parathyroid Glands Safe

Etelcalcetide Injection Into Parathyroid Glands Safe

In a pilot study, investigators observed no harmful effects from etelcalcetide injection, and 5 of 10 of patients had a greater than 50% decline in PTH levels.

Paricalcitol May Be More Efficacious Than Cinacalcet in HD

Paricalcitol May Be More Efficacious Than Cinacalcet in HD

Therapy with paricalcitol alone achieved the greatest decline in intact parathyroid hormone among hemodialysis with secondary hyperparathyroidism.

Biomarkers Predict Renal Function Decline, CV Events

Biomarkers Predict Renal Function Decline, CV Events

High levels of parathyroid hormone and fibroblast growth factor 23 in CKD patients are associated with need for renal replacement therapy or a 50% or greater decline in eGFR.

No iPTH Oversuppression With Extended-Release Calcifediol

No iPTH Oversuppression With Extended-Release Calcifediol

Intact parathyroid hormone levels decline in proportion with SHPT severity in patients taking the drug.

Vitamin D Supplementation Improves PTH, Bone Turnover in CKD

Vitamin D Supplementation Improves PTH, Bone Turnover in CKD

Cholecalciferol can also correct vitamin D deficiency in patients with chronic kidney disease.

Low Protein Diet With Keto Analogues May Prevent SHPT

Low Protein Diet With Keto Analogues May Prevent SHPT

Dialysis patients treated with a low protein diet with keto analogues had lower levels of parathyroid hormone than those on a normal diet, meta-analysis shows.

IV Calcimimetic Benefits Hemodialysis Patients With SHPT

IV Calcimimetic Benefits Hemodialysis Patients With SHPT

By the third month of treatment, 59% of etelcalcetide recipients had reached target iPTH levels of 60 to 240 pg/mL compared with just 1.3% of placebo recipients.

CKD Patients Frequently Re-hospitalized After Parathyroidectomy

CKD Patients Frequently Re-hospitalized After Parathyroidectomy

Parathyroidectomy for hyperparathyroidism in CKD patients is associated with a 30-day readmission rate of 17.2%.

Etelcalcetide Shows Efficacy, Safety Over 52 Weeks

Etelcalcetide Shows Efficacy, Safety Over 52 Weeks

By 52 weeks, 87.5% of patients had reached an intact parathyroid hormone target range of 60 to 240 pg/mL.

Expert Panel: Calcifediol Possibly a Better Option for SHPT

Expert Panel: Calcifediol Possibly a Better Option for SHPT

Calcifediol is possibly more effective at alleviating 25(OH)D deficiency and reducing parathyroid hormone compared with other nutritional vitamin D therapies.

Total Parathyroidectomy Procedures Similarly Efficacious

Total Parathyroidectomy Procedures Similarly Efficacious

Surgical complications and symptom improvement, for example, did not differ significantly between total parathyroidectomy with and without autotransplantation.

Low Vitamin D, High PTH Up Mortality Risk in Early CKD

Low Vitamin D, High PTH Up Mortality Risk in Early CKD

The risk for premature death increased by 62% and 42% for stage 3 CKD patients with vitamin D deficiency and elevated parathyroid hormone levels, respectively.

Parathyroidectomy Associated With Morbidity, Mortality

Parathyroidectomy Associated With Morbidity, Mortality

Single-center study reveals a hospitalization rate of 14% following total parathyroidectomy without autotransplantation.

Efficacy of Paricalcitol vs Other VDRAs Unclear

Efficacy of Paricalcitol vs Other VDRAs Unclear

Meta-analysis shows comparable efficacy in lowering iPTH, but analyses of patient-centered outcomes such as mortality and cardiovascular death were not possible.

Researchers: Iron-based Binders Best for Hyperphosphatemia

Researchers: Iron-based Binders Best for Hyperphosphatemia

Of 7 phosphate binders, iron-based agents were optimal when efficacy and safety are considered.

Most Patients Prefer Medication to Surgery for SHPT

Most Patients Prefer Medication to Surgery for SHPT

New survey shows that out-of-pocket costs are a major concern.

Total Parathyroidectomy for Refractory SHPT Improves Bone Metabolism

Total Parathyroidectomy for Refractory SHPT Improves Bone Metabolism

Bone mineral density in the lumbar spine and femoral neck increased over time in hemodialysis patients who underwent total parathyroidectomy without autotransplantation.

Secondary Hyperparathyroidism Risk Higher in Elderly CKD Patients

Secondary Hyperparathyroidism Risk Higher in Elderly CKD Patients

SHPT in those aged 65 years or older is associated with lower eGFR, low levels of 25-hydroxyvitamin D, and use of furosemide.

Parathyroidectomy Tied With Complications in Secondary, Tertiary Hyperparathyroidism

Parathyroidectomy Tied With Complications in Secondary, Tertiary Hyperparathyroidism

After parathyroidectomy, morbidity and mortality rates were considerably higher in patients with secondary and tertiary vs primary hyperparathyroidism.

Adynamic Bone Disease Prevalent in Type 2 Diabetes Patients With CKD

Adynamic Bone Disease Prevalent in Type 2 Diabetes Patients With CKD

Almost 40% of pre-dialysis patients with stage 4-5 CKD patients and type 2 diabetes had lab results suggesting low turnover bone disease.

High Post-op iPTH Linked With Increased Mortality in SHPT

High Post-op iPTH Linked With Increased Mortality in SHPT

The risk of death more than tripled with iPTH levels above 600 pg/mL at 1 week after surgery.

Total PTx Without Autotransplantation May Improve Outcomes

Total PTx Without Autotransplantation May Improve Outcomes

Meta-analysis reveals a lower risk of recurrence and persistence of SHPT when total parathyoidectomy is performed without transplanting parathyroid tissue.

Guidelines for CKD Mineral and Bone Disorder Updated

Guidelines for CKD Mineral and Bone Disorder Updated

Among other changes, the new KDIGO guidelines highlight the potential dangers of hypercalcemia.

Hip Fracture Rates Falling Among ESRD Patients

Hip Fracture Rates Falling Among ESRD Patients

From 2003 to 2011 there was a 26.7% decrease in in-hospital mortality rate after hip fracture.

Review Supports Sodium Thiosulfate Use for Calciphylaxis

Review Supports Sodium Thiosulfate Use for Calciphylaxis

Patients often received sodium thiosulfate with other therapies.

Novel Parathyroidectomy Procedure May Result in Durably Low PTH

Novel Parathyroidectomy Procedure May Result in Durably Low PTH

Typically, about 2% to 20% of SHPT patients experience recurrence or persistence after conventional parathyroidectomy procedures, likely due to residual parathyroid tissue.

High-Dose Vitamin D May Halt Secondary Hyperparathyroidism Progression

High-Dose Vitamin D May Halt Secondary Hyperparathyroidism Progression

In a study of CKD patients, intact PTH levels remained stable those receiving cholecalciferol 8000 IU daily but increased in placebo recipients.

Cardiothoracic Ratio Predicts Mortality in SHPT Patients

Cardiothoracic Ratio Predicts Mortality in SHPT Patients

Higher CTR was associated with greater risks of death from cardiovascular disease and other causes.

Cinacalcet May Lower Death Risk in Dialysis Subgroups

Cinacalcet May Lower Death Risk in Dialysis Subgroups

Researchers found lower all-cause mortality for cinacalcet-treated patients concomitantly treated with vitamin D and phosphate binders, for example.

Surgery More Effective for Post-Transplant Hyperparathyroidism

Surgery More Effective for Post-Transplant Hyperparathyroidism

Up to half of transplant patients might experience tertiary hyperparathyroidism.

Residual Kidney Function Predicts Mortality in CKD-MBD

Residual Kidney Function Predicts Mortality in CKD-MBD

In a study of hemodialysis patients, mortality risk increased along with phosphorus level, particularly among patients with higher residual renal urea clearance.

High-Volume Surgeons Improve Parathyroidectomy Outcomes

High-Volume Surgeons Improve Parathyroidectomy Outcomes

The researchers found that patients of high-volume surgeons had a lower rate of vocal cord paralysis compared to patients of low-volume surgeons.

Initial Low-Dose Etelcalcetide Feasible for SHPT Patients

Initial Low-Dose Etelcalcetide Feasible for SHPT Patients

At 18 months, PTH levels were within target for 67% and 68% of participants who initiated etelcalcetide at 2.5 mg and 5 mg, respectively.

Sucroferric Oxyhydroxide Ups Phosphorus Control in SHPT

Sucroferric Oxyhydroxide Ups Phosphorus Control in SHPT

Nearly twice as many patients achieved the target phosphorus range after a year of taking the phosphate binder, regardless of iPTH level.

Cinacalcet Appears to Ease Hyperparathyroidism in Transplant Patients

Cinacalcet Appears to Ease Hyperparathyroidism in Transplant Patients

Cinacalcet treatment may serve as a bridge to parathyroidectomy or as an alternative, researchers say.

Eliminating Phosphorus Food Additives Does Not Compromise Nutrition

Eliminating Phosphorus Food Additives Does Not Compromise Nutrition

Replacing foods containing phosphorus-based additives with similar foods not containing these additives can control hyperphospatemia without interfering with nutritional status.

Post-Parathyroidectomy Bone Changes in HD Patients Characterized

Post-Parathyroidectomy Bone Changes in HD Patients Characterized

Researchers using spectral computed tomography found that calcium concentration increased in cortical bone and decreased in cancellous bone.

Study Finds New Clues to CKD Mineral Bone Disease

Study Finds New Clues to CKD Mineral Bone Disease

Bone expression of sclerostin and parathyroid hormone receptor-1 increased in earlier stages of CKD, whereas FGF-23 and phosphorylated b-catenin showed increased expression in later stages.

ALP Predicts Mortality in Peritoneal Dialysis Patients With CKD-MBD

ALP Predicts Mortality in Peritoneal Dialysis Patients With CKD-MBD

Alkaline phosphatase was more strongly linked to mortality compared with other biomarkers of chronic kidney disease-mineral and bone disorder.

PTH-Suppressive Vitamin D Dose in Obese Patients ID'd

PTH-Suppressive Vitamin D Dose in Obese Patients ID'd

Study suggests the lowest dose of vitamin D3 supplements needed to suppress parathyroid hormone in overweight and obese adults is 1000 IU daily.

Initial Low-Dose Cinacalcet Feasible for SHPT Patients

Initial Low-Dose Cinacalcet Feasible for SHPT Patients

In a study, similar proportions of patients taking a low dose and standard dose of cinacalcet had a greater than 30% reduction in iPTH levels at 16 weeks.

Vitamin D Status Linked to Body Fat in Older Women

Vitamin D Status Linked to Body Fat in Older Women

Adipose tissue may be more important than vitamin D intake, new study suggests.

A Case of SHPT Affecting the Skeleton

A Case of SHPT Affecting the Skeleton

Clinicians should be aware of these uncommon radiograph findings.

Novel Calcimimetic Approved for Secondary Hyperparathyroidism

Novel Calcimimetic Approved for Secondary Hyperparathyroidism

Etelcalcetide is the first new approved treatment for the condition in 12 years.

CKD-MBD Biomarker Targets ID'd

CKD-MBD Biomarker Targets ID'd

Priority should be to achieve target calcium levels or simultaneously achieving both phosphorus and iPTH levels, researchers say.

Off-Target CKD-MBD Biomarkers Prognostic for Adverse Outcomes

Off-Target CKD-MBD Biomarkers Prognostic for Adverse Outcomes

Dialysis facilities with the least control of PTH, Ca, and P had the greatest risks.

Why SHPT Requires Management

Why SHPT Requires Management

Clinical practice guidelines recommend that PTH levels be kept within specific ranges to prevent adverse outcomes.

FGF-23 Indirectly Associated With Vascular Calcification

FGF-23 Indirectly Associated With Vascular Calcification

In a small study, 50% of non-diabetic hemodialysis patients with elevated FGF-23 showed correlations with calcification in the abdominal aorta.

Hungry Bone Syndrome Risk Factors ID'd in Total PTx Patients

Hungry Bone Syndrome Risk Factors ID'd in Total PTx Patients

The syndrome is more likely to develop in younger patients and those with higher preoperative ALP levels and lower preoperative calcium levels.

Etelcalcetide Reduces PTH Levels in Moderate to Severe SHPT

Etelcalcetide Reduces PTH Levels in Moderate to Severe SHPT

Benefits over placebo were demonstrated in 2 trials involving hemodialysis patients with moderate to severe secondary hyperparathyroidism.

Safe Alternative SHPT Surgical Approach for Elderly Patients Reported

Safe Alternative SHPT Surgical Approach for Elderly Patients Reported

Good results achieved with total parathyroidectomy without autotransplantation, according to researchers.

Calciphylaxis Linked to Low Vitamin K

Calciphylaxis Linked to Low Vitamin K

An enzyme that inhibits vascular calcification depends on the vitamin for conversion to its active form.

RFA May Have Role in Treating Secondary Hyperparathyroidism

RFA May Have Role in Treating Secondary Hyperparathyroidism

Researchers caution that radiofrequency ablation should only be considered for patients ineligible for parathyroid surgery.

Higher PTH Levels May Increase Risk of Dialyzer Clotting

Higher PTH Levels May Increase Risk of Dialyzer Clotting

Each 100 pg/mL increase in parathyroid hormone was associated with 2-fold increased odds of clotting.

Calcitriol May Be Optimal Vitamin D3 Therapy for SHPT

Calcitriol May Be Optimal Vitamin D3 Therapy for SHPT

In a study, calcitriol showed superior efficacy compared with alfacalcidol with respect to inhibiting parathyroid hormone secretion.

Secondary Hyperparathyroidism Ups Risk of Kidney Allograft Loss

Secondary Hyperparathyroidism Ups Risk of Kidney Allograft Loss

Increased fractional excretion of phosphate also found to increase risk of allograft loss.

Subtotal Parathyroidectomy for SHPT Safe, Effective

Subtotal Parathyroidectomy for SHPT Safe, Effective

Cure rate is significantly higher among patients who have intraoperative monitoring of intact parathyroid hormone level.

Bone Mass Increases After Total Parathyroidectomy

Bone Mass Increases After Total Parathyroidectomy

In a study, 94.1% of total PTx patients had improvement of bone mineral density at their most affected site.

Parathyroidectomy Offers Survival Advantage

Parathyroidectomy Offers Survival Advantage

Surgery decreased the risk of death from any cause by 32% compared with usual treatment.

Parathyroidectomy Rarely Achieves KDIGO Targets

Parathyroidectomy Rarely Achieves KDIGO Targets

Just 6.7% of patients had target levels of calcium, phosphorus, and parathyroid hormone a year after surgery.

Microwave Ablation Effective for Mild to Moderate SHPT

Microwave Ablation Effective for Mild to Moderate SHPT

More patients treated with MWA plus calcitriol reached iPTH levels below 150 pg/mL: 23.33% vs 8.54%.

Cinacalcet Initiated at Varying PTH Levels

Cinacalcet Initiated at Varying PTH Levels

Prior to starting therapy, parathyroid hormone trajectories show different patterns of increase and decrease.

High Intact Parathyroid Hormone Levels Linked With Death in CKD

High Intact Parathyroid Hormone Levels Linked With Death in CKD

Having 3 or 4 CKD-MBD markers in the danger zone more than doubled the chances of early death.

Study Reveals Vitamin D Therapy Effect on Mineral Biomarkers

Study Reveals Vitamin D Therapy Effect on Mineral Biomarkers

Calcitriol and paricalcitol raise levels of fibroblast growth factor 23 and sclerostin and lower levels of some bone turnover markers.

Cinacalcet Possibly Improves Anemia

Cinacalcet Possibly Improves Anemia

SHPT patients who received 6 months of cinacalcet treatment had a 10% increase in the odds of reaching target hemoglobin levels.

Data Support Secondary Hyperparathyroidism Treatment

Data Support Secondary Hyperparathyroidism Treatment

Spontaneous or no decline in parathyroid hormone is associated with higher mortality risk, study finds.

SHPT Surgical Procedures Equally Effective

SHPT Surgical Procedures Equally Effective

Randomized study compared total parathyroidectomy with and without autotransplantation.

Surgical Debridement Improves Survival in Calciphylaxis Patients

Surgical Debridement Improves Survival in Calciphylaxis Patients

Subtotal parathyroidectomy may lower the death risk of patients with secondary hyperparathyroidism and calciphylaxis.

Fewer Post-Transplant Fractures With Practice Changes

Fewer Post-Transplant Fractures With Practice Changes

Fracture incidence within a year of transplant was 3 times lower among patients who had surgery from 2009 to 2011 vs 2004 to 2006.

Parathyroid Hormone Tests Have Limitations

Parathyroid Hormone Tests Have Limitations

High individual biologic variability in PTH levels are among the factors that may make PTH unreliable as a biomarker of outcomes.

Kidney Donors Possibly at Risk for Bone Loss

Kidney Donors Possibly at Risk for Bone Loss

Bone turnover markers increased following unilateral nephrectomy.

Leptin a Potential Target to Reduce CVD Risk in CKD-MBD

Leptin a Potential Target to Reduce CVD Risk in CKD-MBD

Parathyroidectomy may improve leptin regulation and heart rate variability in SHPT patients.

Extended-Release Calcifediol Found Safe, Effective for SHPT

Extended-Release Calcifediol Found Safe, Effective for SHPT

The formulation decreased intact parathyroid hormone levels by at least 10% in 72% of CKD patients with secondary hyperparathyroidism.

Ultrasound Findings May Bolster Indication for Parathyroidectomy

Ultrasound Findings May Bolster Indication for Parathyroidectomy

The presence of parathyroid nodules suggests worse bone metabolic profiles in patients with severe secondary hyperparathyroidism.

Risk Factors for Post-TPTx Severe Hypocalcemia Identified

Risk Factors for Post-TPTx Severe Hypocalcemia Identified

Study implicates male sex and higher preoperative levels of parathyroid hormone and alkaline phosphatase.

Sucroferric Oxyhydroxide Does Not Interact With Oral VDRAs

Sucroferric Oxyhydroxide Does Not Interact With Oral VDRAs

Intact parathyroid hormone decreased in dialysis patients taking sucroferric oxyhydroxide but increased in those taking sevelamer carbonate.

Secondary Hyperparathyroidism Risk Higher With Furosemide Use

Secondary Hyperparathyroidism Risk Higher With Furosemide Use

Study reveals 6-fold higher risk of SHPT in patients on furosemide vs hydrochlorothiazide.

Etelcalcetide Pharmacokinetics Revealed

Etelcalcetide Pharmacokinetics Revealed

No new safety concerns emerged during the study.

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