Secondary Hyperparathyroidism News Archive
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.
Abnormal calcium-phosphate metabolism appears to be an important pathogenic factor in the development of vascular calcification in patients with chronic kidney disease.
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.
iPTH significantly correlated with measures of diastolic dysfunction in patients with non-dialysis chronic kidney disease.
Patients with high alkaline phosphatase prior to PTx should be treated aggressively after surgery to prevent postoperative hypocalcemia, researchers conclude.
In 2 studies, parathyroid hormone (PTH) values 20 minutes after parathyroidectomy predicted PTH levels for 5 years.
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.
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.
Nearly 86% of diabetic nephropathy patients from an Egyptian outpatient center had elevated iPTH levels.
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.
Patients reported less skin itching, joint pain, and muscle weakness after surgery.
ESRD patients with SHPT undergoing surgery had a 26% lower risk for all-cause mortality compared with medical management.
Secondary hyperparathyroidism may have a detrimental effect on successful arteriovenous fistula creation, researcher says.
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.
Therapy with paricalcitol alone achieved the greatest decline in intact parathyroid hormone among hemodialysis with secondary hyperparathyroidism.
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.
Intact parathyroid hormone levels decline in proportion with SHPT severity in patients taking the drug.
Cholecalciferol can also correct vitamin D deficiency in patients with chronic kidney disease.
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.
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.
Parathyroidectomy for hyperparathyroidism in CKD patients is associated with a 30-day readmission rate of 17.2%.
By 52 weeks, 87.5% of patients had reached an intact parathyroid hormone target range of 60 to 240 pg/mL.
Calcifediol is possibly more effective at alleviating 25(OH)D deficiency and reducing parathyroid hormone compared with other nutritional vitamin D therapies.
Surgical complications and symptom improvement, for example, did not differ significantly between total parathyroidectomy with and without autotransplantation.
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.
Single-center study reveals a hospitalization rate of 14% following total parathyroidectomy without autotransplantation.
Meta-analysis shows comparable efficacy in lowering iPTH, but analyses of patient-centered outcomes such as mortality and cardiovascular death were not possible.
Of 7 phosphate binders, iron-based agents were optimal when efficacy and safety are considered.
New survey shows that out-of-pocket costs are a major concern.
Bone mineral density in the lumbar spine and femoral neck increased over time in hemodialysis patients who underwent total parathyroidectomy without autotransplantation.
SHPT in those aged 65 years or older is associated with lower eGFR, low levels of 25-hydroxyvitamin D, and use of furosemide.
After parathyroidectomy, morbidity and mortality rates were considerably higher in patients with secondary and tertiary vs primary hyperparathyroidism.
Almost 40% of pre-dialysis patients with stage 4-5 CKD patients and type 2 diabetes had lab results suggesting low turnover bone disease.
The risk of death more than tripled with iPTH levels above 600 pg/mL at 1 week after surgery.
Meta-analysis reveals a lower risk of recurrence and persistence of SHPT when total parathyoidectomy is performed without transplanting parathyroid tissue.
Among other changes, the new KDIGO guidelines highlight the potential dangers of hypercalcemia.
From 2003 to 2011 there was a 26.7% decrease in in-hospital mortality rate after hip fracture.
Patients often received sodium thiosulfate with other therapies.
Typically, about 2% to 20% of SHPT patients experience recurrence or persistence after conventional parathyroidectomy procedures, likely due to residual parathyroid tissue.
In a study of CKD patients, intact PTH levels remained stable those receiving cholecalciferol 8000 IU daily but increased in placebo recipients.
Higher CTR was associated with greater risks of death from cardiovascular disease and other causes.
Researchers found lower all-cause mortality for cinacalcet-treated patients concomitantly treated with vitamin D and phosphate binders, for example.
Up to half of transplant patients might experience tertiary hyperparathyroidism.
In a study of hemodialysis patients, mortality risk increased along with phosphorus level, particularly among patients with higher residual renal urea clearance.
The researchers found that patients of high-volume surgeons had a lower rate of vocal cord paralysis compared to patients of low-volume surgeons.
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.
Nearly twice as many patients achieved the target phosphorus range after a year of taking the phosphate binder, regardless of iPTH level.
Cinacalcet treatment may serve as a bridge to parathyroidectomy or as an alternative, researchers say.
Replacing foods containing phosphorus-based additives with similar foods not containing these additives can control hyperphospatemia without interfering with nutritional status.
Researchers using spectral computed tomography found that calcium concentration increased in cortical bone and decreased in cancellous bone.
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.
Alkaline phosphatase was more strongly linked to mortality compared with other biomarkers of chronic kidney disease-mineral and bone disorder.
Study suggests the lowest dose of vitamin D3 supplements needed to suppress parathyroid hormone in overweight and obese adults is 1000 IU daily.
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.
Adipose tissue may be more important than vitamin D intake, new study suggests.
Clinicians should be aware of these uncommon radiograph findings.
Etelcalcetide is the first new approved treatment for the condition in 12 years.
Priority should be to achieve target calcium levels or simultaneously achieving both phosphorus and iPTH levels, researchers say.
Dialysis facilities with the least control of PTH, Ca, and P had the greatest risks.
Clinical practice guidelines recommend that PTH levels be kept within specific ranges to prevent adverse outcomes.
In a small study, 50% of non-diabetic hemodialysis patients with elevated FGF-23 showed correlations with calcification in the abdominal aorta.
The syndrome is more likely to develop in younger patients and those with higher preoperative ALP levels and lower preoperative calcium levels.
Benefits over placebo were demonstrated in 2 trials involving hemodialysis patients with moderate to severe secondary hyperparathyroidism.
Good results achieved with total parathyroidectomy without autotransplantation, according to researchers.
An enzyme that inhibits vascular calcification depends on the vitamin for conversion to its active form.
Researchers caution that radiofrequency ablation should only be considered for patients ineligible for parathyroid surgery.
Each 100 pg/mL increase in parathyroid hormone was associated with 2-fold increased odds of clotting.
In a study, calcitriol showed superior efficacy compared with alfacalcidol with respect to inhibiting parathyroid hormone secretion.
Increased fractional excretion of phosphate also found to increase risk of allograft loss.
Cure rate is significantly higher among patients who have intraoperative monitoring of intact parathyroid hormone level.
In a study, 94.1% of total PTx patients had improvement of bone mineral density at their most affected site.
Surgery decreased the risk of death from any cause by 32% compared with usual treatment.
Just 6.7% of patients had target levels of calcium, phosphorus, and parathyroid hormone a year after surgery.
More patients treated with MWA plus calcitriol reached iPTH levels below 150 pg/mL: 23.33% vs 8.54%.
Prior to starting therapy, parathyroid hormone trajectories show different patterns of increase and decrease.
Having 3 or 4 CKD-MBD markers in the danger zone more than doubled the chances of early death.
Calcitriol and paricalcitol raise levels of fibroblast growth factor 23 and sclerostin and lower levels of some bone turnover markers.
SHPT patients who received 6 months of cinacalcet treatment had a 10% increase in the odds of reaching target hemoglobin levels.
Spontaneous or no decline in parathyroid hormone is associated with higher mortality risk, study finds.
Randomized study compared total parathyroidectomy with and without autotransplantation.
Subtotal parathyroidectomy may lower the death risk of patients with secondary hyperparathyroidism and calciphylaxis.
Fracture incidence within a year of transplant was 3 times lower among patients who had surgery from 2009 to 2011 vs 2004 to 2006.
High individual biologic variability in PTH levels are among the factors that may make PTH unreliable as a biomarker of outcomes.
Bone turnover markers increased following unilateral nephrectomy.
Parathyroidectomy may improve leptin regulation and heart rate variability in SHPT patients.
The formulation decreased intact parathyroid hormone levels by at least 10% in 72% of CKD patients with secondary hyperparathyroidism.
The presence of parathyroid nodules suggests worse bone metabolic profiles in patients with severe secondary hyperparathyroidism.
Study implicates male sex and higher preoperative levels of parathyroid hormone and alkaline phosphatase.
Intact parathyroid hormone decreased in dialysis patients taking sucroferric oxyhydroxide but increased in those taking sevelamer carbonate.
Study reveals 6-fold higher risk of SHPT in patients on furosemide vs hydrochlorothiazide.
No new safety concerns emerged during the study.
Serum phosphorus and serum creatinine found to be independent predictors of secondary hyperparathyroidism.
The surgery reduced the risk of death from any cause by 37%, meta-analysis shows.
Over 33 months, the 25-hydroxyvitamin D level of ergocalciferol recipients increased significantly from 15.14 to 37.32 ng/mL.
The risk of peripheral arterial disease was 34% lower for end-stage renal disease patients who underwent the procedure.
SHPT risk was 4 times higher among patients taking furosemide vs hydrochlorothiazide.
Researchers highlighted the benefit of iPTH monitoring.
The debate continues on how best to use parathyroidectomy to treat severe SHPT.
Calcifediol formulation is indicated for CKD stage 3 or 4 patients with secondary hyperparathyroidism associated with vitamin D insufficiency.
No new safety concerns observed in a 52-week extension trial of etelcalcetide in hemodialysis with secondary hyperparathyroidism.
Renal and Urology News Articles
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NEPHROLOGY & UROLOGY NEWS
- Acute Kidney Injury (AKI)
- Chronic Kidney Disease (CKD)
- Contrast Nephropathy
- Cardiovascular Disease (CVD)
- Diabetic Nephropathy
- End-stage Renal Disease (ESRD)
- Lupus Nephritis
- Peritoneal Dialysis
- Secondary Hyperparathyroidism (SHPT)