INTERMITTENT CALCITRIOL THERAPY AND GROWTH IN CHILDREN WITH CHRONIC-RENAL-FAILURE

Intermittent calcitriol (1,25D) therapy has been used for the manageme nt of secondary hyperparathyroidism in children with chronic renal fai lure; however, the development of adynamic bone has been demonstrated in up to 40% of pediatric patients after 12 months of intermittent 1,2 5D therapy. To assess its effect on linear growth, we compared growth and biochemical data from 16 prepubertal patients with biopsy-proven s econdary hyperparathyroidism during 12 months of intermittent 1,25D th erapy and the preceding year of daily 1,25D therapy. While Z-scores fo r height remained stable during daily therapy, values decreased from - 1.8 +/- 0.32 to -2.0 +/- 0.33, p < 0.01. during intermittent 1,25D the rapy: the largest reductions were seen in these who developed adynamic bone. Reductions in growth may be due to the direct inhibitory effect s of large intermittent doses of calcitriol on chondrocyte activity.