Relationship between parathyroid levels and the size and number of the parathyroid glands in renal hyperparathyroidism
Keywords:
parathyroid hormone, Renal hyperparathyroidism, ultrasoundAbstract
Background: The gold standard for diagnosing renal hyperparathyroidism (RH) is serum parathyroid hormone (PTH). Parathyroid gland (PTG) hyperplasia is a result of persistent hyperparathyroidism in patients with chronic kidney disease. Consequently, the PTG size could serve as a substitute indicator for determining the degree of hyperparathyroidism.
Objective: Our study aimed to investigate the relationship between serum PTH levels and the size and number of PTGs in patients with RH.
Methods: We retrospectively identified patients from August 1, 2010, to June 30, 2019, with RH who underwent ultrasonography of the PTGs at our institution. The summations of the maximal diameters and number of enlarged PTGs were collected and compared with the serum PTH levels.
Results: We explored 110 PTGs in 40 patients. Serum PTH levels and the summations of the maximal diameters of the PTGs correlated positively (r = 0.397, P <0.05). There was statistical significance in the prediction of parathyroid enlargement (³3 glands) (AUC = 0.659, 95% CI: 0.482–0.836, P = 0.085). High specificity (>81.0%) was obtained for detecting ³3 parathyroid gland enlargements at a cut-off PTH level of >2,100 pg/ml.
Conclusion: There was a positive correlation between the size of the PTG and the serum PTH levels in RH patients. Individuals with higher PTH levels also had more number of PTGs. The discrepancy between the PTG size and the serum PTH level may indicate further exploration for additional PTGs.
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