ORALPULSE CALCITRIOLTHERAPY IN CHILDREN WITH RENAL OSTEODYSTROPHY

Objective: The aim of this study was to determine the effects and safety of oral pulse calcitriol therapy in patients with renal osteodystrophy (ROD) refractory to the conventional oral vitamin D therapy. Materials and methods: After baseline determination of serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), urea, creatinine, intact parathyroid hormone (iPTH), osteocalcin, calcitriol levels and parathyroid gland ultrasonography, oral pulse calcitriol therapy was started at doses of 2 mu g, three times a week, and all these parameters were followed up for a period of 4-6 months. Results: Serum iPTH levels measured in the 2nd and 6th months were significantly lower than basal serum iPTH levels (p<0.05). Although basal and post-treatment serum osteocalcin and calcitriol levels were in the normal range, increment in serum calcitriol levels and decrement in serum osteocalcin levels were found statistically significant (p<0.05). The changes of serum Ca, P, CaxP levels were not found statistically significant during the study protocol; however, serum ALP levels declined significantly (p<0.05). Conclusion: Our results indicate that oral pulse calcitriol therapy is well tolerated and this treatment can suppress iPTH levels without increasing hypercalcaemia risk in refractory secondary hyperparathyroidism in patients with chronic renal failure.