THE RELATIONSHIP WITH CALCIUM METABOLISM AND BONE TURNOVER OF ULTRASONOGRAPHIC DIMENSIONS OF PARATHYROID GLANDS IN END-STAGE CHRONIC RENAL FAILURE AND THE ROLE OF ERYTHROPOETIN TREATMENT

OBJECTIVE: The aim of the study is to determine the association of parathyroid gland dimensions with hyperparathyroidism and bone disease in patients with end stage chronic renal failure and to demonstrate its association with erythropoietin treatment. MATERIAL AND METHODS: Twenty patients undergoing renal replacement therapy at the continuous ambulatory peritoneal dialysis (CAPD) unit, 40 patients from hemodialysis unit and 40 patients with stage 4 predialysis (GRF 15-29 ml / min) were included in the study. Patient parathyroid ultrasonography, biochemistry-hematology tests and bone mineral densitometry (BMD) measurements were performed. RESULTS: The PTH values of predialysis patients were lower than those of SAPD and hemodialysis patients (respectively p=0.002, p=0.001). Patients with predialysis had a lower number of adenomas than patients with peritoneal dialysis (p=0.015). The parathyroid adenoma volume of patients with predialysis was lower than that of hemodialysis patients (p=0.032). The total erythropoetin (EPO) dose used in the last year; showed positive correlation with PTH level, adenoma number, adenome volume, and bone building markers (osteocalcin and alkaline phosphatase) (respectively r=0.257 p=0.021, r=0.312 p=0.005). Mean PTH values were 496.5 ± 439.7 pg / ml and there was a positive correlation between adenoma volume and PTH secretion (p=0.001). CONCLUSIONS: Patients with the highest autonomic levels of PTH secretion were the patients with the most erythropoetin use. These findings suggest that erythropoetin not only increases parathyroid gland size but also increases autonom