Korean Journal of Nephrology 1994;13(1):162-170.

유지혈액투석환자에서 부갑상선 초음파검사의 의의

이은영 , 최규 복 , 최희정 , 윤건일 , 백승연 , 서정수

Abstract

Background
Secondary hyperparathyroidism is a complication of chronic renal failure caused by various causes and the status of compensatory hypersecretion of parathyroid hormone. In view of its relatively high sensitivity, specificity and simplicity, ultrasonography of the parathyroid glands may be the method of choice to evaluate possible hyperparathyroidism in hemodialysis patients. This study was designed to assess the prevalence and the significance of enlarged parath- yroid glands assessed by ultrasonography in maintenance hemodialysis patients. Methods .' Twenty-nine patients on maintenance hemodialysis for end-stage renal disease were examined by ultrasonography of the parathyroid glands. Labora- tory data included serum intact parathyroid hormone (immunoradiometric assay), alkaline phosphatase, in- organic phosphatase and calcium. Clinical symptoms such as bone and joint pains and plain radiography of the hands were also checked. Based on the presence or absence of ultrasonographically enlarged parathyroid glands, the patients were divided into two groups, and the respective parameters were compared. Result: 1) In eight (27.6%') patients, parathyroid sonography revealed one or several (up to four) enlarged parathyr- oid glands. 2) Patients with enlarged parathyroid glands (group I), compared to those with undetected parathyroid glands as assessed by ultrasonography (group Il), had no statistically significant difference of clinical, bio- chemical, radiological parameters. 3) No significant correlations existed between the serum calcium levels and serum intact parathyroid hormone in group I, but negative correlation (r=0.72, p <0.001) existed in group II. 4) A positive correlations (r=0.74, p<0.05) existed between the duration of hemodialysis and serum intact parathyroid hormone in group I, but no significant correlations existed in group II. Conclusion .' This indicates the development of abnor- mal calcium-related secretion of parathyroid hormone in patients with enlarged parathyroid glands assessed by ultrasonography.