Secondary hyperparathyroidism is a predominant complication of chronic kidney disease caused by disruption of the metabolism of calcium, phosphorus and vitamin D, with high concentrations of serum parathyroid hormone, leading to an increased incidence of cardiovascular and bone disease.
The incidence and prevalence of chronic kidney disease, including renal failure requiring renal replacement therapy, is increasing in Europe.
KDIGO guidelines recommend that all patients with chronic stage 3 kidney disease (GFR <60 mL / min) be monitored and treated for secondary hyperparathyroidism.
This prospective study included 50 patients from the dialysis service, with chronic end-stage kidney disease, under hemodialysis therapy, with hyperplastic parathyroid glands visible on ultrasound and confirmed by biochemical tests and scintigraphy.
Ultrasonography is the most accessible imaging technique for locating parathyroid lesions. It is widely used and is appreciated for its reproducibility, ease of use, non-invasiveness, high resolution, lack of exposure to X-rays and contrast agents, and can be used in children and pregnant women.
However, a major problem in identifying parathyroid lesions, using ultrasonography, is the coexistence of thyroid pathology, being much more common in cases requiring renal replacement therapy than in the general population.
Elastography is an imaging technique that has received special importance in recent years, due to the non-invasive evaluation of the mechanical properties of tissues. This technique provides qualitative and quantitative information, which are used for diagnostic purposes, based on changing the elasticity of the tissue in various pathologies.
The aim of this study is to show the effectiveness of elastography, using Shear Wave elastography (SWE) and real-time elastography (TEN), in the correct identification of hyperplastic glands especially in patients with thyroid lesions and to determine whether the techniques add information in preoperative diagnosis of cases of secondary hyperparathyroidism.
Link to the study (PDF format, RO): The-diagnosis-and-treatment-of-secondary-hyperparathyroidism