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肾衰(即使是早期的)病人,由于磷酸盐的潴留,加上血钙浓度相应降低,可刺激分泌过量的甲状旁腺激素。过去常推荐甲状旁腺次全切除术。本文报告用非手术疗法治疗3例尿毒症时严重继发性甲状旁腺功能亢进症的结果。 3例均为晚期肾病,菊粉清除率4.6～9.1毫升/分。有继发性甲状旁腺机能亢进的全身表现,血钙7.9～8.4毫克/100毫升,血磷6.3～12.0毫克/100毫升。病人不用利尿剂,不补充维生素D,不用透析治疗。先用氢氧化铅凝胶每小时30毫升口服,当血磷浓度下降到正常(3.5毫克/100毫升以下)时,即减量,并加服
In patients with renal failure, even in the early stages, secretion of excess parathyroid hormone can be stimulated due to retention of phosphate and a corresponding decrease in serum calcium concentration. In the past is often recommended subtotal parathyroidectomy. This article reports the results of non-surgical treatment of severe secondary hyperparathyroidism in 3 uremic patients. 3 cases were advanced renal disease, inulin clearance 4.6 ~ 9.1 ml / min. There are secondary systemic manifestations of hyperparathyroidism, serum calcium 7.9 ~ 8.4 mg / 100 ml, phosphorus phosphorus 6.3 ~ 12.0 mg / 100 ml. Patients do not diuretics, do not add vitamin D, no dialysis treatment. Lead hydroxide gel first 30 ml per hour oral, when the serum phosphorus concentration dropped to normal (3.5 mg / 100 ml below), the amount of reduction, and add service