Abstract
We examined 148 parathyroid glands surgically removed because of secondary hyperparathyroidism from 42 patients (29 male, 13 female) with chronic glomerulonephritis on maintenance hemodialysis. Using morphometric analysis, we measured the area occupied by oxyphil cells in a section through the maximum diameter and calculated the ratio to total area (R). We divided the glands and patients into four groups: Group I (R<1%), Group II (1≤R<5%), Group III (5≤R<10%) and Group IV (10%≤R).
1) There were no significant differences between the sexes in age, duration of hemodialysis, serum PTH-C level, or Ca×iP product. 2) The largest number of patients (40.5%) and glands (53.4%) belonged to Group I. 3) Diffuse hyperplasia was dominant in Group I (63.3%), and nodular hyperplasia in Group IV (76.9%). 4) There were no differences in age or serum PTH-C level between the groups of patients. However, patients in Group I, compared with those in Group IV, had a shorter duration of hemodialysis and smaller Ca×iP product. 5) There were positive correlations between total glandular weight and serum PTH-C level, as well as between total weight and total area. No specific tendency was found in the scatter diagram of oxyphil cell area and serum PTH-C level. However, in cases with an oxyphil cell area of more than 10mm2 or an R value of more than 5%, serum PTH-C levels were rather low. The results favor the theory that oxyphil cells may not secrete PTH-C. 6) There was no evidence for tertiary hyperparathyroidism in our 42 patients.
