1α-Hydroxycholecalciferol AND RENAL FUNCTION

Lund, B.; Oh, Sørensen

doi:10.1016/s0140-6736(78)92719-8

Cited by 22 publications

(15 citation statements)

References 7 publications

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“…If they are hypocalcémie, correc tion of this hypocalcemia is appropriate because the degree of hyperparathyroidism is reduced. Furthermore, the correction of hypocalcemia may improve myocardial function [18], However, rendering normocalcemic pa tients hypercalcémie in aiming to suppress their hyper parathyroidism would only partially succeed, and could according to Lund et al [19] lead to further deterioration of renal function. It is worth noting that patients with normocalcemia and only partially suppressible hyper parathyroidism cannot be detected without adopting methods to determine bioactive PTH and iCa.…”

Section: Discussionmentioning

confidence: 99%

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Intact Parathyroid Hormone, Ionized Calcium and Calcium Infusion Test in the Evaluation of Hyperparathyroidism in Chronic Renal Failure

Pietilä

Mörsky

Pasternack

et al. 1987

Nephron

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We studied the parathyroid function in patients with advanced renal failure by determining their plasma concentrations of ionized calcium (iCa), intact parathyroid hormone (PTH) and its inactive metabolites (PTH-MM). The suppressibility of the parathyroidism was studied with a calcium infusion test. The intact PTH values of the nondialysis and dialysis patients did not statistically differ from each other. The concentrations of PTH-MM were, however, higher in the dialysis patients than in the nondialysis patients (p < 0.05). The ratio of PTH-MM to intact PTH was lowest in healthy reference subjects and highest in dialysis patients (p < 0.01), and did not correlate with the degree of intact PTH elevation in the patient groups. The calcium infusion test was carried out on 15 patients. All showed suppression in the elevated plasma intact PTH concentration and in 6 the intact PTH value normalized. The PTH-MM value did not normalize in any of the patients. During oral calcium treatment the degree of intact PTH suppression at an achieved concentration of plasma iCa was predictable from the infusion test. Three patients were parathyroidectomized after the calcium infusion test. In 2 of these elevated intact PTH normalized within 24 h while in 1 no change took place. In this latter case no clinical improvement was noted. We conclude that the determination of plasma intact PTH concentration especially if combined with plasma iCa value is a reliable means of studying the hyperparathyroidism associated with chronic renal failure.

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Section: Discussionmentioning

confidence: 99%

“…This allows an indi vidual adjustment of peroral medication according to the infusion test. Our approach should minimize the re ported danger of further deterioration in renal function by the treatment of disordered calcium homeostasis [19][20][21] which has been associated with hypercalcemia [19].…”

Section: Discussionmentioning

confidence: 99%

Intact Parathyroid Hormone, Ionized Calcium and Calcium Infusion Test in the Evaluation of Hyperparathyroidism in Chronic Renal Failure

Pietilä

Mörsky

Pasternack

et al. 1987

Nephron

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“…Direct renal toxicity of 1-hydroxylated metabolites seems, however, unlikely. Sporadic cases of renal insufficiency have been reported in older subjects treated with excessively high doses (33). None of our patients developed hypercalcaemia, nor was there any significant modification in their renal function as assessed by serum creatinine levels.…”

Section: Biochemical Measurementsmentioning

confidence: 40%

“…D3, 40 to 66% of patients develop (on a normal diet) hypercalcaemia (19)(20)(21) as against less than 20% on 1 p.g/day (4). In certain studies, these hypercalcaemia episodes are accompanied by a moderate increase in serum creatinine levels and a fall in glomerular filtration (3,17,28,33), that are generally reversible once the serum calcium levels have been normalized. Direct renal toxicity of 1-hydroxylated metabolites seems, however, unlikely.…”

Section: Biochemical Measurementsmentioning

confidence: 99%

Prevention of post-menopausal bone loss with 1α-hydroxy vitamin D3 a three-year prospective study

Pouillès¹,

Trémollières²,

Ribot³

1992

Clin Rheumatol

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An open and controlled prospective study was used to assess the preventive efficiency of 1 alpha-hydroxy vitamin D3 (1 alpha (OH) Vit. D3) on post-menopausal vertebral bone loss. Of the 36 patients included in the study, 25 completed two years of treatment with 1 microgram/day of 1 alpha (OH) Vit. D3 and 500 mg of calcium. The vertebral bone mineral density measured by dual photon absorptiometry did not vary in the treated group, whereas it decreased significantly in the control group at the end of the 2 years. At two years, withdrawal of treatment led to a significant bone loss, whereas bone mass remained stable in a subgroup of patients who underwent a third year of treatment with 1 alpha (OH) Vit. D3. Overall, tolerance was satisfactory. However, urinary calcium increased significantly during treatment and one third of the patients developed hypercalciuria > or = 7.5 mmoles/24 h. No variation in either serum calcium or creatinine levels was noted. These results indicate that 1 alpha (OH) Vit. D3 could be useful in preventing post-menopausal bone loss provided it was complemented by regular monitoring of urinary calcium excretion.

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“…20 Treatment with alfacalcidiol has been associated with decreases in GFR. [21][22][23][24][25] These decreases are believed to be associated with the development of nephrocalcinosis. 26 Hypercalciuria has also been observed with calcitriol therapy.…”

Section: Treatmentmentioning

confidence: 99%