The role of 18 F-FCH PET/CT in patients with uremic hyperparathyroidism compared with 99m Tc-sestaMIBI SPECT/CT and ultrasonography

Conclusion18F-FCH PET/CT was more sensitive and accurate for uHPT than99mTc-sestaMIBI SPECT/CT and US, and had better preoperative diagnostic efficacy, particularly for lesions diagnosed as a thyroid nodule by US.
Source: EJNMMI Research - Category: Radiology Source Type: research

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Authors: Pratt RM, West ML, Tennankore KK Abstract Hypercalcemia due to excess parathyroid hormone (PTH) production is a common condition among patients with end-stage renal disease (ESRD), often referred to as tertiary hyperparathyroidism. There are limited effective medical treatment options currently available for such patients. Denosumab is a monoclonal antibody that inhibits osteoclast activation, thereby reducing calcium release from bones. Denosumab has been used to treat medically-refractory hypercalcemia in non-ESRD patients with hyperparathyroidism. Denosumab has also been used to treat non-PTH-mediated h...
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
Authors: Foppiani L, Bottoni G, Piccardo A Abstract A nonagenarian hypertensive man with chronic kidney disease (CKD) was admitted to the emergency department for gastrointestinal symptoms and worsening symptoms of depression. Severe hypercalcemia (15.3 mg/dL) was found and he was hospitalized. Fluids, loop diuretics and glucocorticoids were administered intravenously, which partially reduced calcium levels over a few days and improved his clinical condition. PTH levels proved increased (306 pg/mL) and 25-OHD levels were reduced; primary hyperparathyroidism (PHPT) was diagnosed. Neck ultrasonography (USG) did not s...
Source: Acta Medica: Hradec Kralove - Category: General Medicine Tags: Acta Medica (Hradec Kralove) Source Type: research
Purpose of review Vitamin D deficiency is common in patients with kidney disease and many patients receive vitamin D supplementation. Several large, well-designed clinical trials have been published in the last few years evaluating the effects of vitamin D supplementation on important outcomes for patients with kidney disease including effects on cardiovascular disease, secondary hyperparathyroidism, and kidney disease progression. Recent findings Several negative trials have been published showing no effect of cholecalciferol supplementation on cardiovascular events, kidney disease progression, and albuminuria. Long-...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: CLINICAL NEPHROLOGY: Edited by David S. Goldfarb Source Type: research
AbstractHyperphosphatemia is common in chronic kidney disease (CKD). Often seen as the “silent killer” because of its dramatic effect on vascular calcifications, hyperphosphatemia explains, at least partly, the onset of the complex mineral and bone disorders associated with CKD (CKD–MBD), together with hypocalcemia and decreased 1-25(OH)2 vitamin D levels. The impact of CKD –MBD may be immediate with abnormalities of bone and mineral metabolism with secondary hyperparathyroidism and increased FGF23 levels, or delayed with poor growth, bone deformities, fractures, and vascular calcifications, leading...
Source: Calcified Tissue International - Category: Orthopaedics Source Type: research
AbstractSecondary hyperparathyroidism is part of the complex of chronic kidney disease-associated mineral and bone disorders (CKD-MBD) and is linked with high bone turnover, ectopic calcification, and increased cardiovascular mortality. Therefore, measures for CKD-MBD aim at lowering PTH levels, but there is no general consensus on optimal PTH target values. This manuscript is part of a pros and cons debate for keeping PTH levels within the normal range in children with CKD, focusing on the cons. We conclude that a modest increase in PTH most likely represents an appropriate adaptive response to declining kidney function i...
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
Abstract Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists,...
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
A 28-year-old woman sought care due to an increase in mandible volume lasting approximately 1 year. The patient had chronic kidney disease caused by Berger disease in childhood, and underwent hemodialysis 3 times a week. An intraoral clinical examination revealed an expansive lesion on the left side of the mandible, causing mobility of the adjacent teeth. The radiographic examination showed a lesion of imprecise borders in the region of the right mandible of approximately 2 cm in size. An incisional biopsy and histologic examination revealed a giant cell lesion.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
The brown tumor of hyperparathyroidism is a rare condition associated with excessive production of parathyroid hormone in response to decreased serum calcium levels associated with chronic kidney disease (CKD). A 28-year-old female patient with CKD undergoing hemodialysis presented an asymptomatic swelling in the buccal region of teeth 34 to 44 and mobility of them. Similar swellings were observed on the palate and alveolar ridge distal to tooth 17. On the panoramic radiograph, a radiolucent area not defined by radiopaque halo was observed in the anterior region of the mandible of approximately 2.5 cm in length and radiolu...
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
We report a case of a 30-year-old female patient referred to our clinic with a chief complaint of a painful swelling of the left mandible and difficulty chewing. Her medical history included systemic lupus erythematosus, hypertension, and chronic kidney disease (was on hemodialysis for the past 9 years).
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
Conclusion: Cholecalciferol with adjustment in its dose, and obtaining normal serum levels is an excellent therapeutic alternative for the treatment of patients with CKD stage 3, and hypovitaminosis D. In the group of patients with GFR close to 30 mL/min, or lower values (stage 4), and with the presence of secondary hyperparathyroidism, the use of active form of vitamin D (calcitriol, paricalcitol) is recommended as the first therapeutic alternative. PMID: 31827333 [PubMed]
Source: International Journal of Nephrology and Renovascular Disease - Category: Urology & Nephrology Tags: Int J Nephrol Renovasc Dis Source Type: research
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