LONG-TERM LOW-DOSE CALCITRIOL TREATMENT IN PREDIALYSIS CHRONIC-RENAL-FAILURE - CAN IT PREVENT HYPERPARATHYROID BONE-DISEASE

In an uncontrolled open study 13 patients with moderate to preterminal renal failure were treated with low doses (average 0.36 mu g/day) of calcitriol up to the time of renal transplantation, which was performe d before dialysis had been initiated. A transiliac bone biopsy was obt ained both at the start and at the end of the treatment period, the la tter coinciding with renal transplantation. All patients who started c alcitriol treatment at a creatinine clearance (C-cr) above 30 ml/min h ad normal bone histology at the time of transplantation, but this was not observed when calcitriol treatment was started at C-cr below 30 ml /min. The study suggests that full benefit of calcitriol at the bone l evel is obtained only if prophylactic administration is started early in the course of renal failure.