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Oral calcitriol and calcium: efficient therapy for uremic hyperparathyroidism.
Kidney Int. 1988 Dec; 34(6):840-4.KI

Abstract

Therapy with orally administered calcitriol often does not adequately control the biochemical manifestations of secondary hyperparathyroidism in uremic patients. This may be due to inadequate serum concentrations of 1.25(OH)2 vitamin D and/or to insufficient dietary calcium supplementation. In the present study, therefore, we examined the effect on parathyroid function of calcitriol and calcium carbonate, administered orally, in doses sufficient to normalize the serum 1.25(OH)2 vitamin D and calcium concentrations. After nine months of combined therapy, marked suppression of immunoreactive PTH occurred in the absence of hypercalcemia. Furthermore, prolonged therapy resulted in additional suppression of the PTH concentrations comparable in magnitude to that reported following intravenous calcitriol therapy and was associated with a mild degree of hypercalcemia similar to that which occurs with intravenous therapy. Euparathyroidism was achieved in 25% of the patients by 15 months of treatment. In conclusion, secondary hyperparathyroidism can be effectively controlled with combined oral therapy without significant hypercalcemia in selected patients with end-stage renal failure. This salutary effect may result from direct actions of 1.25(OH)2D on the parathyroid gland and/or gastrointestinal tract, or from an overall action of combined treatment to restore calcium homeostasis.

Authors+Show Affiliations

Department of Medicine, Duke University Medical Center, Durham, North Carolina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

3210546

Citation

Quarles, L D., et al. "Oral Calcitriol and Calcium: Efficient Therapy for Uremic Hyperparathyroidism." Kidney International, vol. 34, no. 6, 1988, pp. 840-4.
Quarles LD, Davidai GA, Schwab SJ, et al. Oral calcitriol and calcium: efficient therapy for uremic hyperparathyroidism. Kidney Int. 1988;34(6):840-4.
Quarles, L. D., Davidai, G. A., Schwab, S. J., Bartholomay, D. W., & Lobaugh, B. (1988). Oral calcitriol and calcium: efficient therapy for uremic hyperparathyroidism. Kidney International, 34(6), 840-4.
Quarles LD, et al. Oral Calcitriol and Calcium: Efficient Therapy for Uremic Hyperparathyroidism. Kidney Int. 1988;34(6):840-4. PubMed PMID: 3210546.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral calcitriol and calcium: efficient therapy for uremic hyperparathyroidism. AU - Quarles,L D, AU - Davidai,G A, AU - Schwab,S J, AU - Bartholomay,D W, AU - Lobaugh,B, PY - 1988/12/1/pubmed PY - 1988/12/1/medline PY - 1988/12/1/entrez SP - 840 EP - 4 JF - Kidney international JO - Kidney Int. VL - 34 IS - 6 N2 - Therapy with orally administered calcitriol often does not adequately control the biochemical manifestations of secondary hyperparathyroidism in uremic patients. This may be due to inadequate serum concentrations of 1.25(OH)2 vitamin D and/or to insufficient dietary calcium supplementation. In the present study, therefore, we examined the effect on parathyroid function of calcitriol and calcium carbonate, administered orally, in doses sufficient to normalize the serum 1.25(OH)2 vitamin D and calcium concentrations. After nine months of combined therapy, marked suppression of immunoreactive PTH occurred in the absence of hypercalcemia. Furthermore, prolonged therapy resulted in additional suppression of the PTH concentrations comparable in magnitude to that reported following intravenous calcitriol therapy and was associated with a mild degree of hypercalcemia similar to that which occurs with intravenous therapy. Euparathyroidism was achieved in 25% of the patients by 15 months of treatment. In conclusion, secondary hyperparathyroidism can be effectively controlled with combined oral therapy without significant hypercalcemia in selected patients with end-stage renal failure. This salutary effect may result from direct actions of 1.25(OH)2D on the parathyroid gland and/or gastrointestinal tract, or from an overall action of combined treatment to restore calcium homeostasis. SN - 0085-2538 UR - https://www.unboundmedicine.com/medline/citation/3210546/Oral_calcitriol_and_calcium:_efficient_therapy_for_uremic_hyperparathyroidism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)34431-8 DB - PRIME DP - Unbound Medicine ER -