J. Rapoport et al., SUCCESSFUL TREATMENT OF SECONDARY HYPERPARATHYROIDISM IN HEMODIALYSIS-PATIENTS WITH ORAL PULSE 1-ALPHA-HYDROXY-CHOLECALCIFEROL THERAPY, Nephron, 72(2), 1996, pp. 150-154
We have used high-dose oral pulse therapy with 1 alpha-hydroxycholecal
ciferol (1 alpha-OH-D-3) to treat 40 hemodialysis patients suffering f
rom secondary hyperparathyroidism. Forty patients with intact parathyr
oid hormone (PTH) levels of > 150 pg/ml were treated with 4 mu g oral
1 alpha-OH-D-3 twice weekly for 1 year. The mean PTH level was 515 +/-
50 pg/ml prior to treatment, which fell to 191 +/- 42 pg/ml after 6 m
onths of treatment (p < 0.00001), and to 164 +/- 39 pg/ml after 12 mon
ths of treatment. Patients with very high PTH levels (> 800 pg/ml) sup
pressed less well than patients with lower levels (150-300 pg/ml). The
therapeutic end point of PTH < 100 pg/ml was achieved in 23 patients
(58%). The main side effect of the treatment was hypercalcemia, but th
is was symptomatic in only 3 patients, all above the age of 70 years.
In summary, oral high-dose pulse therapy with 1 alpha-OH-D-3 was highl
y effective in suppressing PTH levels in hyperparathyroid hemodialysis
patients, and side effects were relatively few.