Objective To analyze the clinical features of shrinking man syndrome in maintenance hemodialysis (MHD) patients, and to discuss the prevention and treatment of the syndrome. Methods We recruited 5 shrinking man syndrome patients undergoing hemodialysis in Blood Purification Center of Beijing Chao-Yang Hospital, Capital Medical University. Parameters including general status, clinical manifestations, height, biochemical examinations (serum total calcium, inorganic phosphate, alkaline phosphatase, intact parathyroid hormone, Hb and hematocrit), bone mineral density, dose and time of vitamin D3 pulse therapy and dose of EPO were collected. Results The hemodialysis age of the 5 patients was more than 10 years. Their body height shortened over 10 cm. All of them had anemia, decreased independent living ability, joint and bone pain, and bone deformities. The face appearance of Sagliker syndrome was found in one patient. All of them had hypercalcemia, osteoporosis, higher serum ALP and serum iPTH. Serum iPTH was as high as >2000pg/ml for more than 3 years, and was unresponsive to pulse administration of vitamin D3. Conclusions Shrinking man syndrome is a specific type of refractory secondary hyperparathyroidism found in MHD patients. Early detection and appropriate treatment of secondary hyperparathyroidism are useful for the prevention of shrinking man syndrome in these patients
