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Percutaneous ethanol injection treatment of severe hyperparathyroidism in maintenance dialysis: Risks and benefits
Author(s) -
GuebreEgziabher Fitsum,
Easy Firas,
Juillard Laurent,
Valette PierreJean,
Fouque Denis
Publication year - 2004
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1492-7535.2004.01098.x
Subject(s) - medicine , hyperparathyroidism , dialysis , surgery , parathyroidectomy , secondary hyperparathyroidism , kidney disease , hemodialysis , perioperative , parathyroid hormone , calcium
Renal hyperparathyroidism is one of the main and serious complications that occur in chronic kidney disease and particularly during long‐term maintenance dialysis. Several recent trials indicate that a high calcium phosphorus product is correlated with high cardiovascular morbidity and mortality and poor outcome. Thus, it is important to improve the control of hyperparathyroidism in chronic renal failure patients. Several methods have been reported for treating severe hyperparathyroidism resistant to medical therapy. Total parathyroidectomy and transplantation or excision of tumor is considered as the treatment of choice. More recently, interventional methods with percutaneous ethanol or calcitriol injection have been developed. These latter techniques have been reported as an alternative to surgical treatment for patients with high perioperative risk. We report the occurrence of laryngeal recurrent nerve palsy, vocal fold paralysis, and hemiplegia after a successful injection of ethanol in a left parathyroid adenoma in a maintenance hemodialysis patient and discuss the restrictions of the procedure and alternative treatments in view of the available studies.