Intraperitoneal calcitriol in infants on peritoneal dialysis.

Abstract

BACKGROUND:

Calcitriol has long been used as the main therapy in renal osteodystrophy, but the efficacy of the oral route is not always as high as expected.

OBJECTIVE:

To asses the safety and efficacy of intraperitoneal calcitriol in infants undergoing peritoneal dialysis (PD).

PATIENTS AND METHODS:

PD patients on oral calcitriol therapy, with serum parathyroid hormone (PTH) >1000 pg/mL during the previous 3 months of treatment, were switched to intraperitoneal calcitriol therapy, 1 microg twice per week. Dose was increased to 1 microg three times per week if PTH remained >1000 pg/mL, and was later readjusted. Target PTH was 200-300 pg/mL according DOQI guidelines.

STATISTICS:

All results are expressed as mean +/- SE. The Wilcoxon signed rank test was used to evaluate differences in measurements for each pair of values. The confidence interval for differences between population medians was 96.9%. A p value less than 0.05 was considered significant.

RESULTS:

Six male children, mean age 17 +/- 3.86 months, completed a 12-month follow-up. Mean pretreatment PTH was 1654 +/- 209 pg/mL. Mean PTH at months 0, 3, 6, 9, and 12 was 1448 +/- 439*, 1277 +/- 723, 910 +/- 704, 582 +/- 282*, and 465 +/- 224* pg/mL, respectively (*p < 0.05). Twelve hypercalcemic and 10 hyperphosphatemic episodes were successfully treated.

CONCLUSION:

Infants on PD who fail to respond to oral calcitriol therapy can be safely treated with intraperitoneal administration of active vitamin D.

• Authors: Francisco J Cano, Marta A Azocar, Jose Luis Guerrero, Maria A Delucchi, Ana Maria Lillo, Marcos Emilfork, Eugenio E Rodríguez
• Journal: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis (Perit Dial Int) 2007 Nov-Dec Vol. 27 Issue 6 Pg. 681-6 ISSN: 0896-8608 [Print] United States
• PMID: 17984431 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Bone Density Conservation Agents
• Parathyroid Hormone
• Phosphorus
• Alkaline Phosphatase
• Calcitriol
• Calcium

Topics

• Alkaline Phosphatase (blood)
• Bone Density Conservation Agents (administration & dosage, adverse effects)
• Calcitriol (administration & dosage, adverse effects)
• Calcium (blood)
• Humans
• Hypercalcemia (chemically induced)
• Hyperparathyroidism, Secondary (drug therapy, etiology)
• Hyperphosphatemia (chemically induced)
• Infant
• Injections, Intraperitoneal
• Kidney Failure, Chronic (blood, complications, therapy)
• Male
• Parathyroid Hormone (blood)
• Peritoneal Dialysis
• Phosphorus (blood)
• Statistics, Nonparametric