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      Comparison of 1α-OH-Vitamin D 3 and High Doses of Calcium Carbonate for the Control of Hyperparathyroidism and Hyperaluminemia in Patients on Maintenance Dialysis

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          Abstract

          27 patients on hemodialysis (dialysate aluminium < 0.7 μmol/l for 2 years, and 2 μmol/l before) whose plasma Ca and PO<sub>4</sub> were adequately controlled for already 6 months by high doses of CaCO<sub>3</sub> alone (mean ± SD: 9 ± 5 g/day), were randomly divided into 2 groups, a control group (c group) which was kept on the same treatment, and a group in which CaCO<sub>3</sub> was reduced to 3 g/day but in which plasma Ca was kept normal due to 1α-OH-vitamin D<sub>3</sub> administration (1 μg/day at the beginning, 0.3 μg/day after 6 months; 1α group) whereas plasma phosphate was kept below 6.0 mg/dl because of A1(OH)<sub>3</sub> (2.7–5 g/day). Initially, the 2 groups were comparable as regards the plasma concentrations of total and ionized Ca, phosphate, alkaline phosphatases, medium and C-terminal parathyroid hormone (PTH) and aluminium, but the control group had lower plasma 25-OH-vitamin D (25-OHD.) After 6 months, the same difference in plasma 25-OHD was found with comparable plasma concentrations of total and ionized calcium as well as of medium and C-terminal PTH (beta error 1%). However, plasma concentration of phosphate and the plasma Ca phosphate product, as well as the plasma aluminium were higher in the 1α group whereas their PCO<sub>3</sub>H was lower. Although the alkaline phosphatase values were not significantly different between the 2 groups, they increased only in the control group because of 1 patient who developed a vitamin-D-deficient osteomalacia (plasma 25-OHD 3 ng/ml), which was subsequently cured by physiological doses of 25-OHD<sub>3</sub>. The incidence of transient hypercalcemia (15 vs. 21 episodes) and worsening of soft tissue calcifications (3 in each group) was the same in the 2 groups.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1985
          1985
          04 December 2008
          : 39
          : 4
          : 309-315
          Affiliations
          aService de Néphrologie, Hôpital Nord, Amiens; bLaboratoire de Biochimie, CHU, Amiens; cUnité de Mathématique Appliquée, Université de Picardie, Amiens; dLaboratoire de Radioimmunologie, Hôpital Lariboisière, Paris, France
          Article
          183396 Nephron 1985;39:309–315
          10.1159/000183396
          3982576
          © 1985 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 7
          Categories
          Original Paper

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