Abstract | BACKGROUND AND OBJECTIVES: DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Patients with stages 3-4 CKD (n=110) with a PTH level >120 pg/ml were recruited and randomized to 0.25 μg/d of calcitriol or 1 μg/d of paricalcitol between April 2009 and July 2011. Subsequent dose adjustments were by protocol to achieve 40%-60% PTH suppression below baseline. The primary endpoint was the rate of confirmed hypercalcemia of >10.5 mg/dl between groups. RESULTS: Forty-five patients in each group completed the 24 weeks of treatment. Both agents suppressed PTH effectively (-52% with paricalcitol and -46% with calcitriol; P=0.17), although the paricalcitol group reached a 40% reduction in PTH sooner at a median 8 weeks (interquartile range [IQR], 4, 12) versus 12 weeks (IQR, 8, 18; P=0.02) and had a lower pill burden of 240 (IQR, 180, 298) versus 292 (IQR, 231, 405; P=0.01). Confirmed hypercalcemia was very low in both groups (three with paricalcitol and one with calcitriol) and was not significantly different (P=0.36). Both groups had small increases in calcium and phosphorus levels (0.3-0.4 mg/dl in each electrolyte) and significant decreases in alkaline phosphatase, a marker of high bone turnover, with no significant differences between groups. CONCLUSIONS:
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Authors | Daniel W Coyne, Seth Goldberg, Mark Faber, Cybele Ghossein, Stuart M Sprague |
Journal | Clinical journal of the American Society of Nephrology : CJASN
(Clin J Am Soc Nephrol)
Vol. 9
Issue 9
Pg. 1620-6
(Sep 05 2014)
ISSN: 1555-905X [Electronic] United States |
PMID | 24970869
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2014 by the American Society of Nephrology. |
Chemical References |
- Ergocalciferols
- paricalcitol
- Calcitriol
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Topics |
- Aged
- Calcitriol
(therapeutic use)
- Ergocalciferols
(therapeutic use)
- Humans
- Hypercalcemia
(chemically induced, epidemiology)
- Hyperparathyroidism, Secondary
(drug therapy, etiology)
- Incidence
- Kidney Failure, Chronic
(complications)
- Middle Aged
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