Time course of change in calcium x phosphorus product after percutaneous ethanol injection therapy.

BACKGROUND

Percutaneous ethanol injection therapy (PEIT) effectively suppresses PTH secretion, but the change in the serum calcium and phosphorus product (Ca x P) after PEIT has not been fully evaluated.

METHODS

Twenty-seven haemodialysis patients with severe secondary hyperparathyroidism (2HPT) were divided into two groups according to their intact PTH (i-PTH) concentrations 6 months after PEIT: (i). effective (E) group, i-PTH concentration <360 pg/ml; and (ii). non-effective (N) group i-PTH > or = 360 pg/ml. The changes in serum calcium and phosphorus concentrations and the Ca x P were recorded for the following 2 years under post-PEIT medical treatment with oral calcitriol or intravenous 22-oxacalcitriol (OCT).

RESULT: In the E group, the i-PTH concentrations decreased to <300 pg/ml 1 year after PEIT (801+/-302 to 280+/-134 pg/ml), then increased to 435+/-201 pg/ml at 2 years. Serum calcium concentration did not show any significant change except for a transient reduction at 1 month after PEIT. The Ca x P decreased for 1 year (from 66.3+/-15.3 to 56.2+/-10.3 mg(2)/dl(2); P<0.05), in agreement with the course of phosphorus concentration, and continued to be <60 mg(2)/dl(2) up to 2 years after PEIT. The Ca x P tended to decrease more with OCT than oral calcitriol. In the N group, calcium and Ca x P increased significantly at 6 months after PEIT and remained at a high value.

CONCLUSION

Treatment with PEIT suppresses serum PTH concentration as well as Ca x P in the long term.