[Indication of parathyroid intervention]

Secondary hyperparathyroidism (SHPT) is one of mineral bone disorders in chronic kidney disease (CKD) , when stage of SHPT become advance, not only responsiveness for drug will be decreased, but also serum parathyroid hormone (PTH), calcium (Ca) , and Pi level become also aggravate. Such a clinical condition is called resistance to medical treatment, and if intact PTH level is over than 500 pg/mL or there is at least one parathyroid grand more than 0.5 cm(3) in size, it is strongly suspected that SHPT becomes advance with resistance to medical treatment. Moreover, hypercalcemia and hyperphosphataemia have also been associated with reduced life expectancy, parathyroid intervention is the treatment choice for SHPT in behalf of medical therapy. Parathyroid intervention has better be chosen when there is resistant to medical treatment, even though intact PTH level is less than 500 pg/mL. Parathyroidectomy is desirable from the long term effect if more than two numbers of glands are detected by ultrasonography. Parathyroid intervention is chosen depending on the degree of SHPT and presence of some complications, and it should be perform in the appropriate period.