Growth of parathyroid gland in uremic patients on maintenance hemodialysis.

High-resolution, real-time ultrasonography was performed in 245 uremic patients on maintenance hemodialysis and the growth of the enlarged parathyroid glands was compared with the clinical and biochemical signs during follow-up periods of 12 months. The total volume of the parathyroid glands was significantly correlated with the serum C-terminal parathyroid hormone (C-PTH; r = 0.379, p = 0.0001) and calcium levels (r = 0.252, p = 0.0224). After 12 months, the total volume of the enlarged parathyroid glands and serum C-PTH or calcium levels were correlated more closely than in the initial study (r = 0.615, p = 0.0001, and r = 0.489, p = 0.0002, respectively). Both the serum C-PTH levels and the total volume of the enlarged parathyroid glands increased significantly (p = 0.0001), while the ratio between the serum C-PTH levels and the volume of the parathyroid glands decreased significantly (p = 0.0001). There was no difference in the clinical and biochemical signs except for the serum aluminum levels between the patients with and without an increased gland volume. These results suggest that the growth of parathyroid glands may progress more rapidly than the increase in the serum PTH levels, independent of the serum calcium levels, in uremic patients on maintenance hemodialysis.