Journal of Clinical Medicine (Nov 2022)

Effectiveness and Safety of Ultrasound-Guided Local Paricalcitol Injection in Treating Secondary Hyperparathyroidism in ESRD: A Retrospective Study

  • Shuqin Xie,
  • Yuan Yu,
  • Yi Liu,
  • Siliang Zhang,
  • Shiyi Yuan,
  • Kui Fan,
  • Bin Tang,
  • Qin Zhou,
  • Yuqing Sun,
  • Rui Liu,
  • Dan Cao,
  • Yong Chen,
  • Yelei Wang,
  • Guangjun Liu,
  • Huan Ma,
  • Chenghui Tao,
  • Li Zeng,
  • Ling Zhong

DOI
https://doi.org/10.3390/jcm11226860
Journal volume & issue
Vol. 11, no. 22
p. 6860

Abstract

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Purpose: To compare the safety and efficacy of percutaneous paricalcitol injection with intravenously administered paricalcitol in treating parathyroid hyperplasia in patients with secondary hyperparathyroidism (SHPT). Methods: This study was approved by the Ethics Committee of our institution. We retrospectively collected data on patients who received percutaneous paricalcitol injection (24 patients) and intravenously administered paricalcitol (22 patients) based on their intact parathyroid hormone (iPTH) level. Serum iPTH, calcium, phosphorus, and the volume of the parathyroid gland were measured at several indicated time points after treatment, and adverse events associated with the two treatments were evaluated. Results: After 6 months of follow-up, we found that patients from the percutaneous injection group had significantly decreased levels of iPTH (from 1887.81 ± 726.81 pg/mL to 631.06 ± 393.06 pg/mL), phosphate (from 1.94 ± 0.36 mmol/L to 1.71 ± 0.34 mmol/L), and volume of the parathyroid gland (from 0.87 ± 0.50 cm3 to 0.60 ± 0.36 cm3), with relief from ostealgia within 48–72 h. In the intravenously administered group, the levels of iPTH decreased from 686.87 ± 260.44 pg/mL to 388.47 ± 167.36 pg/mL; while there was no significant change in phosphate levels, the volume of the parathyroid gland and ostealgia relief were observed at the end of follow-up. The serum calcium level did not significantly change, and no severe complications were observed in both groups. In vitro fluorescence-activated single cell sorting (FACS) analysis indicated that paricalcitol induced parathyroid cell apoptosis in a dose-dependent manner. Conclusions: Percutaneous paricalcitol injection is a selective treatment for SHPT in ESRD.

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