Diameter of parathyroid glands measured by computed tomography as a predictive indicator for response to cinacalcet in dialysis patients with secondary hyperparathyroidism

Yu Ah Hong, Yoo Sun Cho, Sun Woo Kim, Mi Yeon Jung, Eun Ah Lee, Gang Jee Ko, Heui Jung Pyo, Soon Young Hwang, Sangil Suh, Young Joo Kwon

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)

    Abstract

    Background/Aims: Cinacalcet is one of the important treatments of secondary hyperparathyroidism (SHPT). We evaluated the role of computed tomography (CT) for parathyroid glands (PTGs) to determine the response to cinacalcet therapy in dialysis patients. Methods: In study 1, we compared the predictive cutoff values of the largest volume or diameter of PTGs on ultrasonography or CT for achievement of target intact parathyroid hormone (iPTH) level according to K/DOQI guideline after cinacalcet treatment in a single dialysis center. In study 2, the role of the cutoff diameter of PTGs on CT in predicting responsive to cinacalcet therapy was reevaluated in dialysis patients with SHPT in multiple centers. Results: In study 1, among the total population of 26 patients, the number of patients with baseline iPTH over 600 pg/mL was 16 (61%). In study 2, it was 45 (54%), among 82 patients. In study 1, the number of PTGs equal to or larger than the cutoff value (≥ 11.2 mm) on CT, not ultrasonography, was significantly higher in non-responders than in responders (p=0.038). In study 2, the proportion of patients with PTGs ≥ 11.2 mm on CT was significantly higher in non-responders than responders (p=0.003). Multivariate analysis showed that pretreatment iPTH (odds ratio [OR] 1.498, p=0.003) and the existence of enlarged PTGs on CT (OR 8.940, p=0.015) were significant clinical factors affecting the response to cinacalcet. Conclusions: The diameter of PTGs on CT could predict the response to cinacalcet in dialysis patients with SHPT.

    Original languageEnglish
    Pages (from-to)277-287
    Number of pages11
    JournalKidney and Blood Pressure Research
    Volume40
    Issue number3
    DOIs
    Publication statusPublished - 2015 Jun 23

    Keywords

    • Cinacalcet
    • Computed Tomography
    • Hyperparathyroidism, secondary
    • Parathyroid glands
    • Ultrasonography

    ASJC Scopus subject areas

    • Nephrology
    • Cardiology and Cardiovascular Medicine

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