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Calcium‐mediated parathyroid hormone suppression test in uraemic secondary hyperparathyroidism
Author(s) -
Xiang Ting,
Wang Yan,
Lan Tian,
Zhou Li
Publication year - 2021
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13807
Subject(s) - medicine , secondary hyperparathyroidism , parathyroid hormone , parathyroidectomy , endocrinology , hyperplasia , hyperparathyroidism , calcium , urology
Aim The present study aimed to investigate the value of calcium‐mediated parathyroid hormone (PTH) suppression test in evaluating the autonomic secretory function of parathyroid, and the management of uraemic secondary hyperparathyroidism (SHPT). Methods Calcium‐mediated PTH suppression test was performed in dialysis with SHPT, who were candidates for parathyroidectomy from June 2017 to December 2019 in our hospital. The PTH inhibition rate (PTH‐IR) was calculated, and the correlation between PTH‐IR and clinical indicators was explored. Results Fifty‐one subjects were included. PTH‐IR was negatively correlated with baseline PTH ( r = −0.35, P = .012), it was also correlated with dialysis years, coronary artery calcification score (CACS) and parathyroid mass ( r = −0.397, P = .004; r = −0.327, P = .028; r = −0.363, P = .015), which were not found for baseline PTH. Forty‐four patients underwent surgical treatment. According to the histological results, 26 patients presented with parathyroid non‐nodular hyperplasia, and 18 patients presented with parathyroid nodular hyperplasia. The mass of parathyroid of patients with nodular hyperplasia was higher than that of patients with non‐nodular hyperplasia ( ρ = 0.01). The difference of the PTH‐IR was not found between the two groups ( ρ = 0.296). During the test, the highest serum calcium was 2.9 ± 0.4 mmol/L, which dropped to normal at the end of the test. Conclusion Parathyroid hormone inhibition rate might be a useful indicator in evaluating the autonomic secretory function of parathyroid and the progression of SHPT on top of intact PTH. Calcium‐mediated PTH suppression test was safe in uraemic SHPT patients, but need to monitor for transient hypercalcaemia.