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Improvement of severe secondary hyperparathyroidism in dialysis patients by intravenous 1 alpha(OH) vitamin D3, oral CaCO3 and low dialysate calcium.
Kidney Int Suppl. 1993 Jun; 41:S121-4.KI

Abstract

Seventeen patients (9 men, 8 women; aged 27 to 75 years) who were on chronic hemodialysis for 1 to 14 years were included in the study because they had severe hyperparathyroidism diagnosed by elevated plasma alkaline phosphatase and on plasma intact PTH levels more than twice the upper limit of normal. They had been previously treated with various combinations of oral calcium and/or Al(OH)3 as phosphate binders, oral 1 alpha(OH) vitamin D3 metabolites and a dialysate calcium concentration (DCa) of 1.6 to 1.75 mmol/liter. When i.v. alpha calcidol was introduced DCa was reduced to 1.25 mmol/liter and CaCO3 taken with the meal was used as the sole phosphate binder. alpha calcidol was i.v. injected after the third dialysis of the week at a dose up to 4 micrograms per dialysis in order to obtain a predialysis plasma concentration of Ca at 2.5 +/- 0.2 and PO4 between 1.5 and 2 mmol/liter. All the other treatments were discontinued. During the six months of follow-up, the mean weekly dose of alpha calcidol was 6 micrograms and CaCO3 700 +/- 50 mmol. Plasma calcium (PCa) increased moderately from 2.35 to 2.47 mmol/liter (P < 0.05) whereas plasma PO4 (PPO4) did not significantly increase (1.56/1.64 mmol/liter). Total alkaline phosphatase and its bone isoenzyme activity decreased significantly to normal values [respectively from 186 to 83 IU (normal: 135) and from 102 to 32 IU (normal < 33)] whereas plasma intact PTH decreased from 485 to 125 pg/ml (normal < 55).(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Service de Néphrologie CHU, Amiens, Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8320904

Citation

Moriniere, P, et al. "Improvement of Severe Secondary Hyperparathyroidism in Dialysis Patients By Intravenous 1 alpha(OH) Vitamin D3, Oral CaCO3 and Low Dialysate Calcium." Kidney International. Supplement, vol. 41, 1993, pp. S121-4.
Moriniere P, el Esper N, Viron B, et al. Improvement of severe secondary hyperparathyroidism in dialysis patients by intravenous 1 alpha(OH) vitamin D3, oral CaCO3 and low dialysate calcium. Kidney Int Suppl. 1993;41:S121-4.
Moriniere, P., el Esper, N., Viron, B., Judith, D., Bourgeon, B., Farquet, C., Gheerbrant, J., Chapuy, M., Van Orshoven, A., & Pamphile, R. (1993). Improvement of severe secondary hyperparathyroidism in dialysis patients by intravenous 1 alpha(OH) vitamin D3, oral CaCO3 and low dialysate calcium. Kidney International. Supplement, 41, S121-4.
Moriniere P, et al. Improvement of Severe Secondary Hyperparathyroidism in Dialysis Patients By Intravenous 1 alpha(OH) Vitamin D3, Oral CaCO3 and Low Dialysate Calcium. Kidney Int Suppl. 1993;41:S121-4. PubMed PMID: 8320904.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvement of severe secondary hyperparathyroidism in dialysis patients by intravenous 1 alpha(OH) vitamin D3, oral CaCO3 and low dialysate calcium. A1 - Moriniere,P, AU - el Esper,N, AU - Viron,B, AU - Judith,D, AU - Bourgeon,B, AU - Farquet,C, AU - Gheerbrant,J, AU - Chapuy,M, AU - Van Orshoven,A, AU - Pamphile,R, PY - 1993/6/1/pubmed PY - 1993/6/1/medline PY - 1993/6/1/entrez SP - S121 EP - 4 JF - Kidney international. Supplement JO - Kidney Int Suppl VL - 41 N2 - Seventeen patients (9 men, 8 women; aged 27 to 75 years) who were on chronic hemodialysis for 1 to 14 years were included in the study because they had severe hyperparathyroidism diagnosed by elevated plasma alkaline phosphatase and on plasma intact PTH levels more than twice the upper limit of normal. They had been previously treated with various combinations of oral calcium and/or Al(OH)3 as phosphate binders, oral 1 alpha(OH) vitamin D3 metabolites and a dialysate calcium concentration (DCa) of 1.6 to 1.75 mmol/liter. When i.v. alpha calcidol was introduced DCa was reduced to 1.25 mmol/liter and CaCO3 taken with the meal was used as the sole phosphate binder. alpha calcidol was i.v. injected after the third dialysis of the week at a dose up to 4 micrograms per dialysis in order to obtain a predialysis plasma concentration of Ca at 2.5 +/- 0.2 and PO4 between 1.5 and 2 mmol/liter. All the other treatments were discontinued. During the six months of follow-up, the mean weekly dose of alpha calcidol was 6 micrograms and CaCO3 700 +/- 50 mmol. Plasma calcium (PCa) increased moderately from 2.35 to 2.47 mmol/liter (P < 0.05) whereas plasma PO4 (PPO4) did not significantly increase (1.56/1.64 mmol/liter). Total alkaline phosphatase and its bone isoenzyme activity decreased significantly to normal values [respectively from 186 to 83 IU (normal: 135) and from 102 to 32 IU (normal < 33)] whereas plasma intact PTH decreased from 485 to 125 pg/ml (normal < 55).(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0098-6577 UR - https://www.unboundmedicine.com/medline/citation/8320904/Improvement_of_severe_secondary_hyperparathyroidism_in_dialysis_patients_by_intravenous_1_alpha_OH__vitamin_D3_oral_CaCO3_and_low_dialysate_calcium_ L2 - http://www.diseaseinfosearch.org/result/8597 DB - PRIME DP - Unbound Medicine ER -