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A randomized trial of intermittent versus continuous oral alfacalcidol treatment of hyperparathyroidism in end-stage renal disease.
Clin Nephrol. 2006 Jun; 65(6):415-8.CN

Abstract

BACKGROUND

Secondary hyperparathyroidism, a major clinical problem in patients with chronic renal failure, develops in response to phosphate retention and impaired calcitriol [1,25-dihydroxyvitamin D3] synthesis. Vitamin D therapy, particularly alfacalcidol [1 alpha-hydroxyvitamin D3], has been shown to be effective in the treatment of secondary hyperparathyroidism. The aim of this study was to compare the effect of a 12-week course of continuous versus intermittent oral alfacalcidol therapy on parathyroid hormone suppression.

PATIENTS AND METHODS

34 patients were selected and randomly divided into 2 groups to receive either intermittent or continuous oral alfacalcidol. Baseline data were obtained on serum calcium, phosphorus, alkaline phosphatase and PTH. All but the PTH were monitored monthly. PTH levels were measured again until the end of the protocol. The intervention was 2 microg of alfacalcidol given after each dialysis session (intermittent group) or 1 microg given 6 days/week (continuous group).

RESULTS

Serum calcium and phosphorus showed a tendency to increase from baseline levels in both groups. Mean PTH levels for both groups showed a progressive reduction over time during the study period. This decrement showed no significant difference with regard to the schedule of alfacalcidol administration when comparing the 2 groups. There also was no difference in the incidence of side effects--hypercalcemia and hyperphosphatemia--between the intermittent and continuous intervention.

CONCLUSION

Feedback regulation of PTH with oral alfacalcidol therapy is efficient in the treatment of hyperparathyroidism. However, intermittent and continuous oral administration are equally effective in suppressing an elevated PTH level in hemodialysis patients, with similar safety margins.

Authors+Show Affiliations

Department of Nephrology and Dialysis, Ibn Rochd University Hospital Center, Casablanca, Morocco. faissal76@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16792136

Citation

Tarrass, F, et al. "A Randomized Trial of Intermittent Versus Continuous Oral Alfacalcidol Treatment of Hyperparathyroidism in End-stage Renal Disease." Clinical Nephrology, vol. 65, no. 6, 2006, pp. 415-8.
Tarrass F, Yazidi A, Sif H, et al. A randomized trial of intermittent versus continuous oral alfacalcidol treatment of hyperparathyroidism in end-stage renal disease. Clin Nephrol. 2006;65(6):415-8.
Tarrass, F., Yazidi, A., Sif, H., Zamd, M., Benghanem, M. G., & Ramdani, B. (2006). A randomized trial of intermittent versus continuous oral alfacalcidol treatment of hyperparathyroidism in end-stage renal disease. Clinical Nephrology, 65(6), 415-8.
Tarrass F, et al. A Randomized Trial of Intermittent Versus Continuous Oral Alfacalcidol Treatment of Hyperparathyroidism in End-stage Renal Disease. Clin Nephrol. 2006;65(6):415-8. PubMed PMID: 16792136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial of intermittent versus continuous oral alfacalcidol treatment of hyperparathyroidism in end-stage renal disease. AU - Tarrass,F, AU - Yazidi,A, AU - Sif,H, AU - Zamd,M, AU - Benghanem,M G, AU - Ramdani,B, PY - 2006/6/24/pubmed PY - 2006/12/9/medline PY - 2006/6/24/entrez SP - 415 EP - 8 JF - Clinical nephrology JO - Clin. Nephrol. VL - 65 IS - 6 N2 - BACKGROUND: Secondary hyperparathyroidism, a major clinical problem in patients with chronic renal failure, develops in response to phosphate retention and impaired calcitriol [1,25-dihydroxyvitamin D3] synthesis. Vitamin D therapy, particularly alfacalcidol [1 alpha-hydroxyvitamin D3], has been shown to be effective in the treatment of secondary hyperparathyroidism. The aim of this study was to compare the effect of a 12-week course of continuous versus intermittent oral alfacalcidol therapy on parathyroid hormone suppression. PATIENTS AND METHODS: 34 patients were selected and randomly divided into 2 groups to receive either intermittent or continuous oral alfacalcidol. Baseline data were obtained on serum calcium, phosphorus, alkaline phosphatase and PTH. All but the PTH were monitored monthly. PTH levels were measured again until the end of the protocol. The intervention was 2 microg of alfacalcidol given after each dialysis session (intermittent group) or 1 microg given 6 days/week (continuous group). RESULTS: Serum calcium and phosphorus showed a tendency to increase from baseline levels in both groups. Mean PTH levels for both groups showed a progressive reduction over time during the study period. This decrement showed no significant difference with regard to the schedule of alfacalcidol administration when comparing the 2 groups. There also was no difference in the incidence of side effects--hypercalcemia and hyperphosphatemia--between the intermittent and continuous intervention. CONCLUSION: Feedback regulation of PTH with oral alfacalcidol therapy is efficient in the treatment of hyperparathyroidism. However, intermittent and continuous oral administration are equally effective in suppressing an elevated PTH level in hemodialysis patients, with similar safety margins. SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/16792136/A_randomized_trial_of_intermittent_versus_continuous_oral_alfacalcidol_treatment_of_hyperparathyroidism_in_end_stage_renal_disease_ L2 - https://ClinicalTrials.gov/search/term=16792136 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -