Changes in interventional treatment--from the viewpoint of percutaneous ethanol injection therapy.

The environment surrounding secondary hyperparathyroidism treatment has changed and the transition of the guidelines on selective percutaneous ethanol injection therapy (PEIT) for secondary hyperparathyroidism from 2000 to 2006 has been made. The new guidelines emphasize the point that PEIT is best indicated for patients with one enlarged gland. Among treatments, including local vitamin D injection, selective PEIT and parathyroidectomy, cinacalcet is a potent medical treatment and will be a very effective new post-treatment intervention. However, it is expected that some patients will require active intervention based on morphological examination even if biochemical control is possible with cinacalcet administration.