CALCITRIOL PULSE THERAPY FOR SEVERE HYPERPARATHYROIDISM OR CALCIUM SALTS AS PHOSPHATE BINDERS IN RENAL DIALYSIS PATIENTS

The concurrent use of calcitriol (CAL) pulse therapy to reduce parathy roid hormone (PTH) secretion and of calcium (Ca) salts as the most app ropriate phosphate binders was evaluated for over 1 year in a group of 14 patients with good divalent ion control on CaCO3 therapy but with increasing levels of serum intact PTH. CAL pulse therapy was effective and safe in only 2 patients; in the remaining subjects it resulted in hypercalcemia and/or hyperphosphatemia, not reversed by adjusting the dialysate Ca concentration and/ or CaCO3 dose, and had to be stopped. Therefore, CAL pulse therapy does not seem to be compatible with Ca s alts which, in our opinion, deserve priority in the therapy of renal d ialysis patients.