Long-Term Suppression of Secondary Hyperparathyroidism by Intravenous 1α-Hydroxy vitamin D3 in Patients on Chronic Hemodialysis
| Autor: | L. Brandi, H. Daugaard, E. Tvedegaard, P.K. Nielsen, C. Egsmose, T. Storm, K. Olgaard |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
medicine.medical_specialty
Hyperparathyroidism Calcitriol business.industry medicine.medical_treatment Metabolite Alpha (ethology) medicine.disease chemistry.chemical_compound Endocrinology chemistry Nephrology Internal medicine medicine Vitamin D and neurology Secondary hyperparathyroidism Hemodialysis business Cholecalciferol medicine.drug |
| Zdroj: | American Journal of Nephrology. 12:311-318 |
| ISSN: | 1421-9670 0250-8095 |
| DOI: | 10.1159/000168465 |
| Popis: | The effect of intravenous 1 alpha-hydroxyvitamin D3 [1 alpha(OH)D3] on circulating levels of intact parathyroid hormone (PTH 1-84) and COOH-terminal immunoreactive PTH(PTH 53-84) was examined in 13 patients on chronic hemodialysis. Thirteen patients were treated for 300 days (10 months), 9 patients for 520 days (14 months) and 6 patients for 720 days (2 years) with increasing doses of 1 alpha(OH)D3 intravenously under careful control of plasma Ca2+. Blood samples were obtained 1 week before start of treatment and then at every 2nd week. None of the patients had previously been treated with oral vitamin D metabolites. Intact PTH levels were maximally suppressed after 27-33 weeks of treatment by approximately 73%. At the end of the study periods, PTH 1-84 was still suppressed by 78 +/- 4.3% after 300 days, 78 +/- 8.8% after 520 days and 85 +/- 6.5% after 720 days. Plasma Ca2+ was kept within normal levels, but showed an initial increase from 1.14 +/- 0.03 to 1.27 +/- 0.15 mmol/l, and an adjustment of the doses of 1 alpha(OH)D3 was necessary. The present investigation demonstrated (1) that intravenous administration of the 1-hydroxylated vitamin D metabolite 1 alpha(OH)D3 induced a significant decrease in circulating levels of biologically active intact PTH, and (2) that it was possible to maintain the marked suppression of PTH secretion by intravenous treatment of 1 alpha (OH)D3 for up to 2 years. Hypercalcemia could be avoided by careful monitoring of plasma Ca2+ and adjustment of the doses of 1 alpha(OH)D3. |
| Databáze: | OpenAIRE |
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