PMID: 9446007Jan 31, 1998Paper

Oral calcitriol pulse therapy in hemodialysis patients. Effects on histomorphometry of bone in renal hyperparathyroidism

Medizinische Klinik
H SperschneiderK Abendroth

Abstract

Hemodialysis patients with symptomatic renal hyperparathyroidism should only get a surgical parathyroidectomy if the oral calcitriol pulse therapy fails. Unfortunately there is no general accepted recommendation for the dosage and intervals of the oral calcitriol pulse therapy. In 34 hemodialysis patients (9 women, 25 men, mean age: 50 +/- 13 years, mean duration time of dialysis: 20 +/- 30 months) with renal hyperparathyroidism (intact parathormon = iPTH > 20 pmol/l) an oral calcitriol pulse therapy was performed over a period of one year. The initial dosage of calcitriol was 0.1 microgram/kg bwt a week, splitted into two equal dosages given at night. After 3 months the calcitriol dosage was changed according to the iPTH, calcium and phosphate levels. The dialysate calcium concentration was kept constant with 1.5 mmol/l. Before and after one year a bone biopsy was performed. The target level for a successful treatment was < or = 20 pmol/l. In the group of responders (n = 24) the iPTH level decreased significantly (p < 0.01) from 37.5 +/- 3.2 to 14.3 +/- 1.9 pmol/l after a period of 12 months. There was no significant change of the iPTH levels in the 10 non-responders (55.5 +/- 6.5 vs 57.2 +/- 9.7 pmol/l). The incidence of hype...Continue Reading

References

Jan 1, 1978·Acta Medica Scandinavica·H RickersP Rødbro
Apr 1, 1976·Kidney International·H H MallucheW Schoeppe
Jan 1, 1992·Annual Review of Medicine·W G Goodman, J W Coburn
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Dec 1, 1996·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·A GerakisA Billis

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Citations

Sep 6, 2019·Current Osteoporosis Reports·Ezequiel Bellorin-FontKevin J Martin

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