Effective suppression of parathyroid hormone by 1 alpha-hydroxy-vitamin D2 in hemodialysis patients with moderate to severe secondary hyperparathyroidism

摘要: Effective suppression of parathyroid hormone by 1α-hydroxy-vitamin D2 in hemodialysis patients with moderate to severe secondary hyperparathyroidism. Calcitriol, as used for treating hyperparathyroidism, has a low therapeutic index. The safety and efficacy the vitamin D analog, 1α(OH)-vitamin (1αD2), which less toxicity animals than D3, was tested multicenter study 24 hyperparathyroidism [serum intact (i) PTH > 400 pg/ml]. Calcium-based phosphate binders alone were maintain serum phosphorus ≤ 6.9 mg/dl. After eight weeks without calcitriol (washout), oral 1αD2,4 µg/day or 4 µg thrice weekly, started, dose adjusted over 12 iPTH between 130 250 pg/ml. Pre-treatment fell from 672 ± 70 pg/ml (SEM) 289 36 after treatment (P 11.2 mg/dl) necessitate stopping treatment. Neither average P level, incidence hyperphosphatemia, nor changed washout Thus, 1αD2 is highly efficacious suppressing safe despite exclusive use calcium-based phosphate-binders. Future studies should clarify optimal dosage regimen.