Oral paricalcitol for the treatment of secondary hyperparathyroidism in hemodialysis patients

Vickie Wai-Ki Kwong, Chi-Bon Leung, Cheuk-Chun Szeto, Bonnie Ching-Ha Kwan, Kai-Ming Chow, Wing-Fai Pang, Philip Kam-Tao Li
2014 Hong Kong Journal of Nephrology  
Secondary hyperparathyroidism is common amongst dialysis patients and is associated with increased morbidity and mortality. Vitamin D analogues are effective treatments, but the adverse effects of traditional vitamin D preparations, especially hypercalcemia, are often dose-limiting. Purpose: We studied the efficacy and safety of paricalcitol for the treatment of secondary hyperparathyroidism in hemodialysis patients. Methods: We reviewed 13 adult hemodialysis patients treated with oral
more » ... with oral paricalcitol. The dosage of paricalcitol was adjusted according to the clinical response. Results: Serum parathyroid hormone (PTH) level decreased by 47.3 AE 34.3% at 3 months and 74.7 AE 36.8 % by 3 years. Eight patients (62%) responded and had reduction in PTH levels by at least 30%; seven of them (87.5%) responded within the first 3 months. Responders had a significantly lower baseline PTH level than the nonresponders (64.3 AE 32.2 vs. 138.5 AE 64.0 pmol/L, p Z 0.02). None of the patients developed hypercalcemia, but hyperphosphatemia was present in all patients. Conclusion: There is a substantial improvement in PTH levels by paricalcitol treatment in hemodialysis patients with secondary hyperparathyroidism, and paricalcitol is generally well tolerated. Our results suggest that patients with more advanced secondary hyperparathyroidism tend to have a less favorable response. 背景:在血液透析患者間,次發性甲狀旁腺功能亢進是常見的疾病,會明顯增加患者的死亡與患 病率。維生素 D 類似物通常是有效的療法,但傳統製劑的臨床應用常受限於不良作用如高鈣血症 的出現。本研究以患有次發性甲狀旁腺功能亢進的血液透析患者為對象,調查了 paricalcitol 在 這方面的功效與安全性。 方法:本研究回顧了 13 位成年血液透析患者,正在接受口服 paricalcitol 治療,其劑量根據臨床 反應作出調整。
doi:10.1016/j.hkjn.2014.02.002 fatcat:thcxj5mhkjg67kcgkzhew4taye