Review Article

Vitamin D Receptor Activators and Clinical Outcomes in Chronic Kidney Disease

Table 5

Parathyroid hyperplasia.

AuthorYearStudyOutcome

Okuno et al. [27]2003 patients treated with maxacalcitol (PTH >300 pg/ml; mean maximal diameter of parathyroid glands 11.0 ± 0.7 mm before treatment), divided in two groups:
group S gland diameter <11.0 mm versus group L with gland diameter >11.0 mm. Parathyroid volume was measured by ultrasonography.
At 4–24 weeks after administration of maxacalcitol, intact PTH concentrations decreased significantly in group S ( ), versus group L.
Serum calcium increased significantly in group L ( ), versus group S.
Glands larger than 11 mm do not adequately respond to treatment.

Shiizaki et al. [28]2003 patients with SHPT and enlarged parathyroid glands were treated by percutaneous maxacalcitol injection therapy (PMIT) under ultrasonographic guidance consecutively 6 times, followed by i.v. maxacalcitol.PMIT and subsequent i.v. maxacalcitol administration significantly decreased PTH levels and parathyroid gland volume for at least 12 weeks.

Akizawa and Kurokawa [29]2002A trial on the long-term administration of maxacalcitol (3 times weekly for 26 weeks subsequent to a 26-week pretrial) in 124 dialysis patients with secondary hyperparathyroidism.PTH levels fell promptly and significantly and were well controlled for one year. Serum calcium levels rose significantly, but within a physiological range. Hypercalcemia (33.1%) was resolved or ameliorated after the withdrawal or dose reduction of maxacalcitol.

Saito et al. [30]2010An outpatient treatment regimen using percutaneous maxacalcitol injection therapy (PMIT) on a weekly basis for 4–6 weeks following dialysis.Intact PTH decreased from 797 to 253 pg/mL.
Ultrasonographic examination detected a gradual reduction in parathyroid gland volume from 1.27 to 0.24 cm3.