INTRAVENOUS CALCITRIOL AS A TREATMENT OF SECONDARY REFRACTORY HYPERPARATHYROIDISM IN TERMINAL CHRONIC-RENAL-FAILURE

被引:0
作者
ALMIRALL, J
TORREGROSA, V
ARRIZABALAGA, P
CASES, A
OLIVA, J
机构
[1] HOSP CLIN BARCELONA,UNIDAD TRASPLANTE RENAL,BARCELONA 36,SPAIN
[2] HOSP CLIN BARCELONA,SERV NEFROL,BARCELONA 36,SPAIN
[3] HOSP CREU ROJA DE BARCELONA,UNIDAD NEFROL,BARCELONA,SPAIN
来源
MEDICINA CLINICA | 1994年 / 102卷 / 09期
关键词
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: In advanced cases of secondary hyperparathyroidism (HPT) in terminal chronic renal failure, the oral treatment of calcitriol is not possible due to the development of hypercalcemia. It has been demonstrated that calcitriol directly inhibits the secretion of parathormone (PTH), independently of calcium. Therefore the intravenous administration of high and intermittent doses of calcitriol (ivVD) has been proposed as an alternative treatment for resistant HPT. METHODS: The response of PTHi to treatment over 6 months with ivVD was evaluated in 18 patients with moderate-severe HPT resistent to the classical schedules. RESULTS: An Important decrease was observed in the PTHi values (basal: 698 +/- 277 pg/ml, end of treatment: 272 +/- 200; p < 0.05). Alkaline phosphatase values followed a parallel course (basal: 476 +/- 286 U/l, end of treatment: 301 +/- 276 U/l, p < 0.05). Fifty-five percent of the patients presented hypercalcemia at some time (Ca greater-than-or-equal-to 11.5 mg/dl) being controlled by a decrease in the dosis of calcitriol or calcium in dialysis fluid. No response was observed in 3 patients (17 %) with treatment being discontinued due to presentation of uncontrollable CONCLUSIONS: The administration of intravenous calcitriol at high and intermittent doses is effective in a considerable number of patients with hyperparathyroidism resistent to the classical oral schedules. Its use may avoid surgical parathyroidectomy in some cases.
引用
收藏
页码:325 / 328
页数:4
相关论文
共 28 条
[1]  
ANDRESS D, 1989, N ENGL J MED
[2]   EFFECT OF INTRAVENOUS 1-ALPHA-HYDROXYVITAMIN-D3 ON SECONDARY HYPERPARATHYROIDISM IN CHRONIC UREMIC PATIENTS ON MAINTENANCE HEMODIALYSIS [J].
BRANDI, L ;
DAUGAARD, H ;
TVEDEGAARD, E ;
STORM, T ;
OLGAARD, K .
NEPHRON, 1989, 53 (03) :194-200
[3]  
BROWN AJ, 1990, KIDNEY INT, V38, pS22
[4]   THE NONCALCEMIC ANALOG OF VITAMIN-D, 22-OXACALCITRIOL, SUPPRESSES PARATHYROID-HORMONE SYNTHESIS AND SECRETION [J].
BROWN, AJ ;
RITTER, CR ;
FINCH, JL ;
MORRISSEY, J ;
MARTIN, KJ ;
MURAYAMA, E ;
NISHII, Y ;
SLATOPOLSKY, E .
JOURNAL OF CLINICAL INVESTIGATION, 1989, 84 (03) :728-732
[5]  
CANTLEY LK, 1985, ENDOCRINOLOGY, V117
[6]  
COBURN JW, 1990, KIDNEY INT, V38, pS54
[7]  
DELMEZ JA, 1989, J CLIN INVEST, V83
[8]  
DUNLAY R, 1989, KIDNEY INT, V36
[9]  
FEINFELD D, 1988, KIDNEY INT, V33
[10]  
FUKAGAWA M, 1990, NEW ENGL J MED, V323, P421