Ca-free hemodialysis as a parathyroid function test in chronic renal failure patients on maintenance hemodialysis

• Published in: Journal of Japanese Society for Dialysis Therapy Vol. 25; no. 9; pp. 1057 - 1061
• Main Authors: Inoue, Seishi, Fujita, Yoshikazu, Hirabayashi, Toshiaki, Azuma, Masayuki
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Dialysis Therapy 1992
• Subjects: Ca free hemodialysis; intact-PTH; parathyroidectomy
• ISSN: 0911-5889; 1884-6211
• DOI: 10.4009/jsdt1985.25.1057

Parathyroid hormone (PTH) response to hypocalcemia was studied in 16 hemodialysis patients with different levels of parathyroid function. There were 10 patients with normal parathyroid function, 3 with severe hyperparathyroidism, 4 who had undergone parathyroidectomy and 4 who were aparathyroid. Hypocalcemia during hemodialysis was produced by Ca-free hemodialysis for 60 min followed by the use of Ca 3.5mEq/l dialysate for 240 min. Serum total Ca and ionized Ca showed the lowest levels during the test at 60 min. Intact-PTH patients attained maximum levels at 30 or 60 min after Ca-free HD. The differences in changes according to group were as follows. The 10 patients with clinically normal parathyroid function exhibited a mild increase in intact-PTH (Δintact-PTH 110 pg/ml). The 3 patients with severe hyperparathyroidism exhibited a marked increase in intact-PTH (Δintact-PTH 400-1, 000 pg/ml) and, after PTX, the patterns became normal. The 2 aparathyroid patients showed no response to hypocalcemic stimulation, and their PTH levels remained in the very low range. In conclusion, hypocalcemic stimulation during Ca-free hemodialysis is useful in evaluating the level of parathyroid function in chronic renal failure patients on hemodialysis.