Long-Term Effect of Intravenous Calcitriol on the Treatment of Severe Hyperparathyroidism, Parathyroid Gland Mass and Bone Mineral Density in Haemodialysis Patients

Abstract

We conducted this study on 15 chronic haemodialysis patients to evaluate the efficacy of i.v. calcitriol over a 1-year period in the treatment of severe secondary hyperparathyroidism (HPT), in particular its effect on bone mineral density (BMD) and parathyroid gland mass. Mean age was 39 ± 11.9 (20-65) years and dialysis duration was 58 ± 3 (19-130) months, i.v. calcitriol was given at a dose of 1 µg post-dialysis 3 times/week for 3 weeks; the dose was then adjusted to maintain the total serum calcium at less than 2.88 mmol/l. The maximum dose was 3 µg 3 times/week. Serum calcium (Ca) and phosphorus (P) were determined prior to treatment, then weekly for 6 weeks and every 2 weeks thereafter. Skeletal survey, dual photon densitometry and parathyroid ultrasound (US) were done prior to treatment and after 1 year. Bone biopsy was done in 10 patients at the beginning of treatment. There was a significant reduction (p 2 (p 2 (p