[PEIT is the part of strategy for severe hyperparathyroidism in patients requiring hemodialysis].

Marked parathyroid hyperplasia is one of the characteristic features of severe hyperparathyroidism in patients requiring chronic hemodialysis. Most of these patients become resistant to conservative therapies such as calcitriol pulse therapy. For these patients, surgical removal of the enlarged parathyroid glands is usually necessary to control parathyroid hormone secretion. Recently, hyperparathyroidism in some of these patients have been managed by percutaneous ethanol injection therapy (PEIT) due to progress of imaging technology. In this study, we consider parathyroidectomy (PTx) and PEIT as a strategy of severe hyperparathyroidism patients. We conclude that PEIT, which is safe and effective therapy for 2HPT, makes possible to maintain long-term parathyroid function within the normal range. However 20% patients after PEIT need to convert PTx:parathyroidectomy after PEIT.