Correction of secondary hyperparathyroidism (SHPT) with intravenous alfacalcidol in patients on program hemodialysis
Abstract
The effect of intravenous ”pulse-therapy” with alfacalcidol (ETALPHA) was studied in 16 dialysis SHPT patients. Average doses of ETALPHA depended on the severity of SHPT and ranged from 3 to 9 mg per week. The treatment consisted of several stages and included intravenous and oral therapy with alfacalcidol. The total duration of the study was 11 months. Resolution of SHPT was observed in 2 patients (13%), in 14 patients (87%) a decrease in serum iPTH level was achieved. In those patients with severe SHPT who responded to the treatment serum iPTH decreased by 50% (from 1185,6 ± 374 to 612,2 ± 377 pg/ml, М ± SD). In patients with moderate SHPT serum iPTH level decreased by 63% from the baseline of 623,27 ± 121 to 228,27 ± 123,06 pg/ml. A target iPTH level (<300 pg/ml) was achieved in 3 patients (19%), oversupression of parathyroid hormone production was detected in 3 patients (19%). Normalization of bone formation markers (alkaline phosphatase and bone specific alkaline phosphatase) and of bone resorbtion marker (b-crosslaps) was observed in all patients including those who had progressive increase of the iPTH level. Treatment with alfacalcidol led to normalization of bone resorbtion markers in 12 patients (75%) and of bone formation markers in 13 patients (81%). Conclusion. Intravenous alfacalcidol therapy has advantage over oral treatment because it gives the opportunity to use higher doses of alfacalcidol, which may be needed to control parathyroid glands function, with lower risk of violation of calcium-phosphorus metabolism.
About the Authors
A. V. Borisov
ЦЭТ «Фесфарм»
Russian Federation
Russian Federation
A. I. Mordik
ЦЭТ «Фесфарм»
Russian Federation
Russian Federation
E. V. Borisova
ЦЭТ «Фесфарм»
Russian Federation
Russian Federation
I. P. Ermakova
НИИТиИО МЗ и СР РФ
Russian Federation
Russian Federation
L. Y. Rozhinskaya
ГУ ЭНЦ РАМН; г. Москва
Russian Federation
Russian Federation
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Review
For citations:
Borisov A.V., Mordik A.I., Borisova E.V., Ermakova I.P., Rozhinskaya L.Y. Correction of secondary hyperparathyroidism (SHPT) with intravenous alfacalcidol in patients on program hemodialysis. Nephrology and Dialysis. 2009;11(3):236-241. (In Russ.)
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