In a prospective study the prevalence of sonographically enlarged parathyroid glands in patients on maintenance hemodialysis was investigated and correlated with clinical and laboratory findings of secondary hyperparathyroidism. We examined 97 unselected patients with a 5 MHz probe. In 34% (33/97) a total of 69 parathyroid glands were detected with a statistically significant correlation between the period of dialysis and the incidence of parathyroid enlargement; 47.8% of the glands were hypoechoic, 34.8% moderately echogenic and 17.3% gave echoes similar to the normal thyroid parenchyma. A correlation was found between the finding of enlarged parathyroid glands and blood levels of calcium and alkaline phosphatase. Parathyroid enlargement was found sonographically before, or in the absence of clinical and laboratory findings of secondary hyperparathyroidism. Sonography is therefore a useful technique for early diagnosis of hyperparathyroidism in patients on maintenance dialysis.
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