Oral vitamin D3 pulse therapy for overt secondary hyperparathyroidism at pre-dialysis stage

Watanabe, Yoshihiko; Inaguma, Daijo; Fukuzawa, Y.; Kumon, Shinichi; Yamazaki, Chikao

doi:10.1093/oxfordjournals.ndt.a027439

Cited by 3 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, most of these studies were inadequately designed due to their uncontrolled nature [21][22][23][24][25][26][27][28], small number of patients [21], lack of stratification according to basal iPTH plasma levels [29,30], or finally to variation of calcitriol intake according to the "clinical need." For instance, Watanabe et al [31] compared the effects of an oral cumulative weekly dose of 1.75 µg/week with a cumulative pulse dose of 8 µg/week. Only Herrmann et al [4] stratified patients according to iPTH plasma levels and compared the same weekly dose of calcitriol given either daily or intermittently to adult dialysis patients over a period of 12 weeks.…”

Section: Discussionmentioning

confidence: 99%

Calcitriol pulse therapy is not more effective than daily calcitriol therapy in controlling secondary hyperparathyroidism in children with chronic renal failure

Ardissino¹,

Schmitt

Testa³

et al. 2000

Pediatric Nephrology

View full text Add to dashboard Cite

Calcitriol oral pulse therapy has been suggested as the treatment of choice for secondary hyperparathyroidism, but its efficacy and safety are still under discussion. The present randomized multicenter study compares the effect of an 8-week course of daily versus intermittent (twice weekly) calcitriol therapy on parathyroid hormone (PTH) suppression in 59 children (mean age 8.4+/-4.7 years) with chronic renal insufficiency (mean Ccr 22.4+/-11.6 ml/min per 1.73 m2) and secondary hyperparathyroidism. After a 3-week washout period, the patients were randomly assigned to treatment with daily oral calcitriol (10 ng/kg per day) or intermittent oral calcitriol (35 ng/kg given twice a week). The calcitriol dose was not changed throughout the study period of 8 weeks. At start of the study, the median intact PTH (iPTH) level was 485 pg/ml (range 83-2032) in the daily group (n=29) and 315 pg/ml (range 93-1638) in the intermittent group (n=30). After 8 weeks, the respective median iPTH concentrations were 232 pg/ml (range 63-1614) and 218 pg/ml (range 2-1785) (ns). The mean iPTH decrease from baseline was 19.2+/-57.8% and 13.7+/-46.7% respectively (not significant). Calcitriol reduced the iPTH concentration in 23/29 patients in the daily group and in 21/30 in the intermittent group. One episode of hypercalcemia (>11.5 mg/dl) was observed in both groups and a single episode of hyperphosphatemia (>7.5 mg/dl) was observed in the daily group. It is concluded that oral calcitriol pulse therapy does not control secondary hyperparathyroidism more effectively than the daily administration of calcitriol in children with chronic renal failure prior to dialysis.

show abstract