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Early intervention with intravenous or pulse oral vitamin D therapy is more effective in the treatment of secondary hyperparathyroidism.
Ther Apher Dial. 2010 Aug 01; 14(4):424-31.TA

Abstract

The K/DOQI clinical practice guidelines recommend vitamin D therapy should be started when the intact parathyroid hormone (iPTH) exceeds 300 pg/mL in patients with secondary hyperparathyroidism. To examine whether the effect of vitamin D therapy on mineral metabolism and parathyroid gland growth varies according to the stage of secondary hyperparathyroidism and iPTH level, 47 patients with secondary hyperparathyroidism received either intravenous or pulse oral vitamin D therapy. The patients were divided into two groups based on the iPTH level at the start of vitamin D therapy: the P(<300) group (N = 23) with iPTH <300 pg/mL; and the P(>or=300) group (N = 24) with iPTH >or=300 pg/mL. We examined serial changes in several serum mineral parameters and parathyroid gland volume and the cumulative incidence of parathyroidectomy in the first two years. Serum calcium, phosphorus, calcium-phosphorus product, and iPTH levels of the P(>or=300) group were significantly higher than those of the P(<300) group, and could not be maintained within the target ranges set by the K/DOQI guidelines. In contrast, the serum levels of phosphorus, calcium-phosphorus product, and iPTH were maintained within the target ranges and the parathyroid gland did not enlarge in the P(<300) group. The cumulative incidence of parathyroidectomy in the P(>or=300) group was significantly higher than in the P(<300) group. Early intervention with intravenous or pulse oral vitamin D therapy at serum iPTH <300 pg/mL can control serum phosphorus, calcium-phosphorus product, and PTH levels to the target ranges and slow the progression of secondary hyperparathyroidism.

Authors+Show Affiliations

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20649764

Citation

Yamada, Shunsuke, et al. "Early Intervention With Intravenous or Pulse Oral Vitamin D Therapy Is More Effective in the Treatment of Secondary Hyperparathyroidism." Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, vol. 14, no. 4, 2010, pp. 424-31.
Yamada S, Taniguchi M, Tokumoto M, et al. Early intervention with intravenous or pulse oral vitamin D therapy is more effective in the treatment of secondary hyperparathyroidism. Ther Apher Dial. 2010;14(4):424-31.
Yamada, S., Taniguchi, M., Tokumoto, M., Tsuruya, K., Hirakata, H., & Iida, M. (2010). Early intervention with intravenous or pulse oral vitamin D therapy is more effective in the treatment of secondary hyperparathyroidism. Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, 14(4), 424-31. https://doi.org/10.1111/j.1744-9987.2010.00817.x
Yamada S, et al. Early Intervention With Intravenous or Pulse Oral Vitamin D Therapy Is More Effective in the Treatment of Secondary Hyperparathyroidism. Ther Apher Dial. 2010 Aug 1;14(4):424-31. PubMed PMID: 20649764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early intervention with intravenous or pulse oral vitamin D therapy is more effective in the treatment of secondary hyperparathyroidism. AU - Yamada,Shunsuke, AU - Taniguchi,Masatomo, AU - Tokumoto,Masanori, AU - Tsuruya,Kazuhiko, AU - Hirakata,Hideki, AU - Iida,Mitsuo, PY - 2010/7/24/entrez PY - 2010/7/24/pubmed PY - 2010/11/3/medline SP - 424 EP - 31 JF - Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy JO - Ther Apher Dial VL - 14 IS - 4 N2 - The K/DOQI clinical practice guidelines recommend vitamin D therapy should be started when the intact parathyroid hormone (iPTH) exceeds 300 pg/mL in patients with secondary hyperparathyroidism. To examine whether the effect of vitamin D therapy on mineral metabolism and parathyroid gland growth varies according to the stage of secondary hyperparathyroidism and iPTH level, 47 patients with secondary hyperparathyroidism received either intravenous or pulse oral vitamin D therapy. The patients were divided into two groups based on the iPTH level at the start of vitamin D therapy: the P(<300) group (N = 23) with iPTH <300 pg/mL; and the P(>or=300) group (N = 24) with iPTH >or=300 pg/mL. We examined serial changes in several serum mineral parameters and parathyroid gland volume and the cumulative incidence of parathyroidectomy in the first two years. Serum calcium, phosphorus, calcium-phosphorus product, and iPTH levels of the P(>or=300) group were significantly higher than those of the P(<300) group, and could not be maintained within the target ranges set by the K/DOQI guidelines. In contrast, the serum levels of phosphorus, calcium-phosphorus product, and iPTH were maintained within the target ranges and the parathyroid gland did not enlarge in the P(<300) group. The cumulative incidence of parathyroidectomy in the P(>or=300) group was significantly higher than in the P(<300) group. Early intervention with intravenous or pulse oral vitamin D therapy at serum iPTH <300 pg/mL can control serum phosphorus, calcium-phosphorus product, and PTH levels to the target ranges and slow the progression of secondary hyperparathyroidism. SN - 1744-9987 UR - https://www.unboundmedicine.com/medline/citation/20649764/Early_intervention_with_intravenous_or_pulse_oral_vitamin_D_therapy_is_more_effective_in_the_treatment_of_secondary_hyperparathyroidism_ L2 - https://doi.org/10.1111/j.1744-9987.2010.00817.x DB - PRIME DP - Unbound Medicine ER -