Intravenous alfacalcidol once weekly pulse therapy for secondary hyperparathyroidism in hemodialysis patients.

Abstract

BACKGROUND:

This study was carried out to assess the efficacy of intravenous administration of alfacalcidol once weekly versus thrice weekly in patients with poorly controlled secondary hyperparathyroidism.

METHODS:

Thirty-six hemodialysis patients with intact parathyroid hormone (i-PTH) > 31.8 pmol/L were divided into two groups. Eighteen patients (Group 1) were given once weekly alfacalcidol for 6 months. The starting dose was 3 µg, which was increased or decreased by 1 µg per week. Eighteen patients (Group 2) were given thrice weekly alfacalcidol for 6 months. The starting dose was 1 µg, which was increased or decreased by 0.5 µg per dose. The dose was increased or decreased according to serum-corrected calcium (CCa), phosphorus (P), and i-PTH. Serum-CCa and P were measured weekly, whereas serum i-PTH and alkaline phosphatase were determined every month.

RESULTS:

Intact-PTH reduced significantly (p < 0.001) from 86 ± 33.20 pmol/L to 31.04 ± 7.77 pmol/L and from 83.64 ± 32.12 pmol/L to 33.09 ± 11.37 pmol/L post-treatment in Groups 1 and 2, respectively. Fifty-six percent of the patients had i-PTH ≤ 31.8 pmol/L at the last observation. Serum alkaline phosphatase reduced significantly (p < 0.001) from 227.94 ± 129.86 IU/L to 163.17 ± 95.29 IU/L and from 285.39 ± 232.36 IU/L to 202.56 ± 165.84 IU/L post-treatment in Groups 1 and 2, respectively. There were no significant differences in serum levels of CCa, P, or their product.

CONCLUSION:

Intravenous alfacalcidol thrice or once weekly is safe and effectively reduced the levels of i-PTH in hemodialysis patients.

• Authors: Eid Mohamed El-Shafey, Ali Eid Alsahow, Gamal Fathy El-Nagar, Amal Ezzat
• Journal: Renal failure (Ren Fail) Vol. 33 Issue 3 Pg. 329-33 ( 2011) ISSN: 1525-6049 [Electronic] England
• PMID: 21401359 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Bone Density Conservation Agents
• Hydroxycholecalciferols
• alfacalcidol

Topics

• Adult
• Aged
• Bone Density Conservation Agents (administration & dosage)
• Female
• Humans
• Hydroxycholecalciferols (administration & dosage)
• Hyperparathyroidism, Secondary (drug therapy, etiology)
• Infusions, Intravenous
• Kidney Failure, Chronic (complications)
• Male
• Middle Aged
• Prospective Studies
• Renal Dialysis