Reduced Risk of Hypercalcemia for Hemodialysis Patients by Administering Calcitriol at Night

Schaefer, K.; Herrath, D. von

doi:10.1016/s0272-6386(12)80955-3

Cited by 44 publications

(25 citation statements)

References 10 publications

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“…For example, nocturnal administration of calcitriol reduced dialysis patients' risk of hypercalcemia. 13 Perhaps the most dramatic examples of temporal optimization of treatment are from chemotherapy. 14,15 In metastatic colorectal carcinoma, for example, antitumor activity was maximized and adverse effects minimized by the administration of 5-fluorouracil and leucovorin during the early morning.…”

Section: Commentmentioning

confidence: 99%

Survival by Time of Day of Hemodialysis in an Elderly Cohort

Bliwise

Kutner²,

Zhang³

et al. 2001

JAMA

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Section: Commentmentioning

confidence: 99%

Survival by Time of Day of Hemodialysis in an Elderly Cohort

Bliwise

Kutner²,

Zhang³

et al. 2001

JAMA

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“…Calcitriol or doxercalciferol were given orally thrice weekly-Mondays, Wednesdays, and Fridays-at bedtime to minimize the impact of vitamin D sterol on intestinal calcium and phosphorus absorption (22). The initial doses were based on PTH levels (19): when values were Ͻ600 pg/ml, the doses of calcitriol and doxercalciferol were 0.5 and 2.5 g, respectively; when PTH levels were Ͼ600 pg/ml, the initial doses were 1.0 and 5.0 g/dose for calcitriol and doxercalciferol, respectively.…”

Section: Study Protocolmentioning

confidence: 99%

Sevelamer Controls Parathyroid Hormone–Induced Bone Disease as Efficiently as Calcium Carbonate without Increasing Serum Calcium Levels during Therapy with Active Vitamin D Sterols

Salusky¹,

Goodman²,

Sahney³

et al. 2005

Journal of the American Society of Nephrology

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Little is known about the impact of various phosphate binders on the skeletal lesions of secondary hyperparathyroidism (2°HPT). The effects of calcium carbonate (CaCO 3 ) and sevelamer were compared in pediatric peritoneal dialysis patients with bone biopsy-proven 2°HPT. Twenty-nine patients were randomly assigned to CaCO 3 (n ‫؍‬ 14) or sevelamer (n ‫؍‬ 15), concomitant with either intermittent doses of oral calcitriol or doxercalciferol for 8 mo, when bone biopsies were repeated. Serum phosphorus, calcium, parathyroid hormone (PTH), and alkaline phosphatase were measured monthly. The skeletal lesions of 2°HPT improved with both binders, and bone formation rates reached the normal range in approximately 75% of the patients. Overall, serum phosphorus levels were 5.5 ؎ 0.1 and 5.6 ؎ 0.3 mg/dl (NS) with CaCO 3 and sevelamer, respectively. Serum calcium levels and the Ca ؋ P ion product increased with CaCO 3 ; in contrast, values remained unchanged with sevelamer (9.6 ؎ 01 versus 8.9 ؎ 0.2 mg/dl; P < 0.001, respectively). Hypercalcemic episodes (>10.2 mg/dl) occurred more frequently with CaCO 3 (P < 0.01). Baseline PTH levels were 980 ؎ 112 and 975 ؎ 174 pg/ml (NS); these values decreased to 369 ؎ 92 (P < 0.01) and 562 ؎ 164 pg/ml (P < 0.01) in the CaCO 3 and the sevelamer groups, respectively (NS between groups). Serum alkaline phosphatase levels also diminished in both groups (P < 0.01). Thus, treatment with either CaCO 3 or sevelamer resulted in equivalent control of the biochemical and skeletal lesions of 2°HPT. Sevelamer, however, maintained serum calcium concentrations closer to the lower end of the normal physiologic range, thereby increasing the safety of treatment with active vitamin D sterols.

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“…We administered the vitamin D in the dialysis unit following dialysis treatment, so as to ensure com pliance. There is evidence that if the drug is taken at night, hypercalcemia may be reduced [14].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Secondary Hyperparathyroidism in Hemodialysis Patients with Oral Pulse 1-Alpha-Hydroxycholecalciferol Therapy

Rapoport¹,

Mostoslavski²,

Ben-David³

et al. 1996

Nephron

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We have used high-dose oral pulse therapy with 1α-hydroxycholecalciferol (1α –OH-D₃) to treat 40 hemodialysis patients suffering from secondary hyperparathyroidism. Forty patients with intact parathyroid hormone (PTH) levels of > 150 pg/ml were treated with 4 µg oral 1α-OH-D₃ twice weekly for 1 year. The mean PTH level was 515 ± 50 pg/ml prior to treatment, which fell to 191 ± 42 pg/ml after 6 months of treatment (p < 0.00001), and to 164 ± 39 pg/ml after 12 months of treatment. Patients with very high PTH levels ( > 800 pg/ml) suppressed less well than patients with lower levels (150-300 pg/ml). The therapeutic end point of PTH < 100 pg/ml was achieved in 23 patients (58%). The main side effect of the treatment was hypercalcemia, but this was symptomatic in only 3 patients, all above the age of 70 years. In summary, oral high-dose pulse therapy with 1α -OH-D₃ was highly effective in suppressing PTH levels in hyperparathyroid hemodialysis patients, and side effects were relatively few.

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Reduced Risk of Hypercalcemia for Hemodialysis Patients by Administering Calcitriol at Night

Cited by 44 publications

References 10 publications

Survival by Time of Day of Hemodialysis in an Elderly Cohort

Survival by Time of Day of Hemodialysis in an Elderly Cohort

Sevelamer Controls Parathyroid Hormone–Induced Bone Disease as Efficiently as Calcium Carbonate without Increasing Serum Calcium Levels during Therapy with Active Vitamin D Sterols

Successful Treatment of Secondary Hyperparathyroidism in Hemodialysis Patients with Oral Pulse 1-Alpha-Hydroxycholecalciferol Therapy

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