Calcitriol pulse therapy is not more effective than daily calcitriol therapy in controlling secondary hyperparathyroidism in children with chronic renal failure |
| |
Authors: | G Ardissino C P Schmitt S Testa A Claris-Appiani O Mehls |
| |
Institution: | (1) Unit of Pediatric Nephrology, Dialysis and Transplantation, Department of Pediatrics, Via Commenda 9, 20122 Milan, Italy e-mail: ardissino@mbox.medit.it Tel.: +39-02-57992466, Fax: +39-02-55011488, IT;(2) Division of Pediatric Nephrology, University Children’s Hospital, Heidelberg, Germany, DE |
| |
Abstract: | Calcitriol oral pulse therapy has been suggested as the treatment of choice for secondary hyperparathyroidism, but its efficacy
and safety are still under discussion. The present randomized multicenter study compares the effect of an 8-week course of
daily versus intermittent (twice weekly) calcitriol therapy on parathyroid hormone (PTH) suppression in 59 children (mean
age 8.4±4.7 years) with chronic renal insufficiency (mean Ccr 22.4±11.6 ml/min per 1.73 m2) and secondary hyperparathyroidism. After a 3-week washout period, the patients were randomly assigned to treatment with
daily oral calcitriol (10 ng/kg per day) or intermittent oral calcitriol (35 ng/kg given twice a week). The calcitriol dose
was not changed throughout the study period of 8 weeks. At start of the study, the median intact PTH (iPTH) level was 485
pg/ml (range 83–2032) in the daily group (n=29) and 315 pg/ml (range 93–1638) in the intermittent group (n=30). After 8 weeks, the respective median iPTH concentrations were 232 pg/ml (range 63–1614) and 218 pg/ml (range 2–1785)
(ns). The mean iPTH decrease from baseline was 19.2±57.8% and 13.7±46.7% respectively (not significant). Calcitriol reduced
the iPTH concentration in 23/29 patients in the daily group and in 21/30 in the intermittent group. One episode of hypercalcemia
(>11.5 mg/dl) was observed in both groups and a single episode of hyperphosphatemia (>7.5 mg/dl) was observed in the daily
group. It is concluded that oral calcitriol pulse therapy does not control secondary hyperparathyroidism more effectively
than the daily administration of calcitriol in children with chronic renal failure prior to dialysis.
Received: 29 September 1999 / Revised: 2 February 2000 / Accepted: 9 February 2000 |
| |
Keywords: | Secondary hyperparathyroidism Pulse calcitriol Intermittent calcitriol Chronic renal failure |
本文献已被 PubMed SpringerLink 等数据库收录! |
|