[Intervention therapy for secondary hyperparathyroidism].

We reported that selective PEIT in parathyroid glands guided by color doppler flow mapping is effective for severe secondary hyperparathyroidism (2HPT) in chronic dialysis patients. According to the recent Survey by the Japanese Working Group on PEIT of Parathyroid, more than 600 patients have been treated by PEIT in Japan by September, 1998. Based on the results of this survey and based on pathophysiological consideration, Working Group proposed a guideline of selective PEIT of parathyroid. I give a brief summary here. But PEIT has a risk of side effects such as recurrent nerve palsy. Recently another way of percutaneous injection therapy (PIT) using Calcitriol, maxacalcitol and acetic acid has been developed and used. These data suggest that parathyroid intervention (IVR) is an effective adjunct to medical therapy for the management of hyperparathyroidism in uremia.