| | |  | | | | Record from Web of Science® | | | | | | |
| THE EFFECT OF LONG-TERM INTRAVENOUS CALCITRIOL ADMINISTRATION ON PARATHYROID FUNCTION IN HEMODIALYSIS-PATIENTS |
|
|
| Author(s): RODRIGUEZ M, FELSENFELD AJ, WILLIAMS C, PEDERSON JA, LLACH F |
| Source: JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY Volume: 2 Issue: 5 Pages: 1014-1020 Published: NOV 1991 |
| Times Cited: 119 References: 30 |
| Abstract: Secondary hyperparathyroidism is common in dialysis patients. Intravenous calcitriol has proven to be an effective therapy for the reduction of parathyroid hormone (PTH) levels. However, the effect of i.v. calcitriol on parathyroid function, defined as the sigmoidal PTH-calcium curve developed during hypocalcemia and hypercalcemia, has not been evaluated during the prolonged administration of i.v. calcitriol. Six hemodialysis patients with marked secondary hyperparathyroidism, PTH levels greater than 500 pg/mL (normal, 10 to 65 pg/mL), were treated for 42 wk with 2-mu-g of i.v. calcitriol after each hemodialysis. Parathyroid function was evaluated before and after 10 and 42 wk of calcitriol therapy. Between baseline and 42 wk, the basal PTH level decreased from 890 +/- 107 to 346 +/- 119 pg/mL (P < 0.02) and the maximally stimulated PTH level decreased from 1293 +/- 188 to 600 +/- 140 pg/mL (P < 0.01). In addition, calcitriol administration significantly decreased PTH levels throughout the hypocalcemic range of the PTH-calcium curve. Although the slope of the PTH-calcium curve (with maximal PTH as 100%) decreased between baseline and 42 wk (P < 0.05), the set point of calcium did not change. Two patients with a decrease in both basal and maximally stimulated PTH levels after 10 wk of calcitriol, developed marked hyperphosphatemia between 10 and 42 wk; this resulted in an exacerbation of hyperparathyroidism despite continued calcitriol therapy. In conclusion, prolonged i.v. calcitriol administration is an effective treatment for secondary hyperparathyroidism in hemodialysis patients provided that reasonable control of the serum phosphate is achieved. In addition, the slope of the PTH-calcium curve may be a better indicator of parathyroid cell sensitivity than the set point of calcium. |
| Document Type: Article |
| Language: English |
Addresses:
1. WADSWORTH VET ADM MED CTR, DEPT MED, LOS ANGELES, CA USA
2. UNIV CALIF LOS ANGELES, LOS ANGELES, CA 90024 USA
3. VET ADM MED CTR, DEPT MED, OKLAHOMA CITY, OK 73104 USA
4. UNIV OKLAHOMA, HLTH SCI CTR, OKLAHOMA CITY, OK 73190 USA |
| Publisher: WILLIAMS & WILKINS, 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 |
| Subject Category: Urology & Nephrology |
| IDS Number: GQ774 |
| ISSN: 1046-6673 |
|
| | | | | | | | | Record from Web of Science® | | | | | | | | | |