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. 2022 Nov 21;11(22):6860.
doi: 10.3390/jcm11226860.

Effectiveness and Safety of Ultrasound-Guided Local Paricalcitol Injection in Treating Secondary Hyperparathyroidism in ESRD: A Retrospective Study

Shuqin Xie  1 , Yuan Yu  1 , Yi Liu  1 , Siliang Zhang  1 , Shiyi Yuan  2 , Kui Fan  1 , Bin Tang  1 , Qin Zhou  1 , Yuqing Sun  1 , Rui Liu  3 , Dan Cao  4 , Yong Chen  5 , Yelei Wang  6 , Guangjun Liu  7 , Huan Ma  3 , Chenghui Tao  8 , Li Zeng  1 , Ling Zhong  1
Affiliations

Effectiveness and Safety of Ultrasound-Guided Local Paricalcitol Injection in Treating Secondary Hyperparathyroidism in ESRD: A Retrospective Study

Shuqin Xie et al. J Clin Med. .

Abstract

Purpose: To compare the safety and efficacy of percutaneous paricalcitol injection with intravenously administered paricalcitol in treating parathyroid hyperplasia in patients with secondary hyperparathyroidism (SHPT).

Methods: This study was approved by the Ethics Committee of our institution. We retrospectively collected data on patients who received percutaneous paricalcitol injection (24 patients) and intravenously administered paricalcitol (22 patients) based on their intact parathyroid hormone (iPTH) level. Serum iPTH, calcium, phosphorus, and the volume of the parathyroid gland were measured at several indicated time points after treatment, and adverse events associated with the two treatments were evaluated.

Results: After 6 months of follow-up, we found that patients from the percutaneous injection group had significantly decreased levels of iPTH (from 1887.81 ± 726.81 pg/mL to 631.06 ± 393.06 pg/mL), phosphate (from 1.94 ± 0.36 mmol/L to 1.71 ± 0.34 mmol/L), and volume of the parathyroid gland (from 0.87 ± 0.50 cm3 to 0.60 ± 0.36 cm3), with relief from ostealgia within 48-72 h. In the intravenously administered group, the levels of iPTH decreased from 686.87 ± 260.44 pg/mL to 388.47 ± 167.36 pg/mL; while there was no significant change in phosphate levels, the volume of the parathyroid gland and ostealgia relief were observed at the end of follow-up. The serum calcium level did not significantly change, and no severe complications were observed in both groups. In vitro fluorescence-activated single cell sorting (FACS) analysis indicated that paricalcitol induced parathyroid cell apoptosis in a dose-dependent manner.

Conclusions: Percutaneous paricalcitol injection is a selective treatment for SHPT in ESRD.

Keywords: end stage renal disease (ESRD); intravenously paricalcitol (IP); local paricalcitol injection (LPI); secondary hyperparathyroidism (SHPT).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Gland volume change of the LPI group. The ultrasound image of the parathyroid gland before (A) and after (B) LPI treatment. The CT image of the parathyroid gland (red arrow) before (C) and after (D) LPI treatment. (E) Violet plot showing the volume change between LPI and IP treatment. * p < 0.05.
Figure 2
Figure 2
FACS analysis of paricalcitol inducing parathyroid cells apoptosis. (A–F) was treated with ethanol as control, (G–L) was treated with paricalcitol.
See this image and copyright information in PMC

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