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      Clinical Effect of Intravenous Calcitriol Administration on Secondary Hyperparathyroidism


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          Background/Aims: Although the PTH-suppressive effect of intravenous calcitriol has already been demonstrated by various studies, the precise dose-response to calcitriol has not been fully determined for uremic secondary hyperparathyroidism (2HPT). In order to investigate in detail the dose-response of intravenous calcitriol and the adequate initial dose against 2HPT, a randomized prospective double-blind study was conducted. Method: One-hundred and sixty-two patients with 2HPT undergoing hemodialysis three times per week were randomly assigned to four calcitriol (Ro21-5535) treatment groups, 0 (placebo), 1, 1.5 or 2 µg. Calcitriol or placebo was given intravenously after each dialysis for 12 weeks under double-blind conditions. Results: Calcitriol dose-dependently reduced both intact-PTH and high-sensitivity assay mid-terminal (HS)-PTH levels. The rate of per-week change in intact-PTH was 0.0% in the placebo group, –7.8% in the 1-µg group, –18.9% in the 1.5-µg group and –24.1% in the 2-µg group. Calcitriol dose-dependently increased the rate of increase in serum Ca adjusted by albumin level. The per-week increases in adjusted serum Ca were –0.01, 0.08, 0.23 and 0.35 mg/dl in the placebo, 1-, 1.5- and 2-µg groups, respectively. Although the degree of PTH suppression was correlated with the adjusted serum Ca increase, by-patients investigation revealed that the number of patients with suppression of PTH despite of no or slight elevation of adjusted serum Ca level was largest in the 1-µg group among the three calcitriol groups. Conclusion: Intravenous calcitriol was found to have a clear dose-dependent effect on PTH reduction in patients with 2HPT, and the appropriate initial dose of this agent was determined to be 1 µg per dialysis session.

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          Author and article information

          S. Karger AG
          April 2002
          08 April 2002
          : 90
          : 4
          : 413-423
          aFujigaoka Hospital, Showa University, Yokohama; bWakayama Medical University, Wakayama; cSchool of Medicine, Tokai University, Isehara; dTokyo Medical and Dental University, Tokyo; eTokyu Hospital, Tokyo; fDepartments of Medicine, University of Niigata, and gOsaka City University Hospital, Osaka; hDepartments of Medicine, University of Okayama, and iCancer Institute Hospital, Tokyo; jSchool of Health Sciences and Nursing, Faculty of Medicine, University of Tokyo; kTokyo Women’s Medical University, School of Medicine, Tokyo; lGerontology Research Institute Morishita Memorial Hospital, Sagamihara, and mShinrakuen Hospital, Niigata, Japan
          54729 Nephron 2002;90:413–423
          © 2002 S. Karger AG, Basel

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          Page count
          Figures: 7, Tables: 3, References: 8, Pages: 11
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/54729
          Self URI (text/html): https://www.karger.com/Article/FullText/54729
          Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
          Original Paper

          Cardiovascular Medicine,Nephrology
          Calcitriol,Secondary hyperparathyroidism,Serum intact-PTH level,Dose dependency,Double-blind method


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