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Intermittent intravenous followed by intermittent oral 1 alpha(OH)D3 treatment of secondary hyperparathyroidism in uraemia.
J Intern Med. 1996 Apr; 239(4):353-60.JI

Abstract

OBJECTIVES

To examine whether intermittent oral 1 alpha(OH)D3 treatment of patients on haemodialysis with secondary hyperparathyroidism (HPT) was able to maintain the marked suppression of PTH, which previously had been induced by an intermittent intravenous administration of 1 alpha(OH)D3. Simultaneously, the effect of the different routes of administration of 1 alpha(OH)D3 on the circulating levels of N- and C-terminal PTH fragments was measured.

DESIGN

An open study of patients on chronic haemodialysis.

SETTING

Renal division, Rigshospitalet, Copenhagen, Denmark.

SUBJECTS

A total of 26 patients started and five patients completed the total protocol.

INTERVENTIONS

The treatment protocol was divided into three parts: (i) 1 alpha(OH)D3 administered intravenously for > 300 days; then (ii) 1 alpha(OH)D3 administered orally for 100 days, followed by (iii) 1 alpha(OH)D3 administered intravenously again for another 100 days. 1 alpha(OH)D3 was given three times a week at the end of each dialysis.

MAIN OUTCOME MEASURES

Intact PTH, N- and C-terminal PTH.

RESULTS

Intact PTH levels were significantly (P < 0.0001) suppressed by 90.4 +/- 3.3% after 56 days of intermittent intravenous 1 alpha(OH)D3 treatment. This degree of suppression remained stable during the following period of oral treatment and did not change further when intravenous treatment was reinstituted. The circulating levels of intact PTH and N- and C-terminal iPTH were not influenced by the administered route of 1 alpha(OH)D3.

CONCLUSIONS

Intravenous 1 alpha(OH)D3 treatment of the secondary HPT in dialysis patients can safely be changed to oral treatment at the time when optimal suppression of PTH has been achieved.

Authors+Show Affiliations

Medical Department P, Rigshospitalet, University of Copenhagen, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8774390

Citation

Brandi, L, et al. "Intermittent Intravenous Followed By Intermittent Oral 1 alpha(OH)D3 Treatment of Secondary Hyperparathyroidism in Uraemia." Journal of Internal Medicine, vol. 239, no. 4, 1996, pp. 353-60.
Brandi L, Daugaard H, Egsmose C, et al. Intermittent intravenous followed by intermittent oral 1 alpha(OH)D3 treatment of secondary hyperparathyroidism in uraemia. J Intern Med. 1996;239(4):353-60.
Brandi, L., Daugaard, H., Egsmose, C., Tvedegaard, E., Kjaerulff Nielsen, P., & Olgaard, K. (1996). Intermittent intravenous followed by intermittent oral 1 alpha(OH)D3 treatment of secondary hyperparathyroidism in uraemia. Journal of Internal Medicine, 239(4), 353-60.
Brandi L, et al. Intermittent Intravenous Followed By Intermittent Oral 1 alpha(OH)D3 Treatment of Secondary Hyperparathyroidism in Uraemia. J Intern Med. 1996;239(4):353-60. PubMed PMID: 8774390.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intermittent intravenous followed by intermittent oral 1 alpha(OH)D3 treatment of secondary hyperparathyroidism in uraemia. AU - Brandi,L, AU - Daugaard,H, AU - Egsmose,C, AU - Tvedegaard,E, AU - Kjaerulff Nielsen,P, AU - Olgaard,K, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 353 EP - 60 JF - Journal of internal medicine JO - J. Intern. Med. VL - 239 IS - 4 N2 - OBJECTIVES: To examine whether intermittent oral 1 alpha(OH)D3 treatment of patients on haemodialysis with secondary hyperparathyroidism (HPT) was able to maintain the marked suppression of PTH, which previously had been induced by an intermittent intravenous administration of 1 alpha(OH)D3. Simultaneously, the effect of the different routes of administration of 1 alpha(OH)D3 on the circulating levels of N- and C-terminal PTH fragments was measured. DESIGN: An open study of patients on chronic haemodialysis. SETTING: Renal division, Rigshospitalet, Copenhagen, Denmark. SUBJECTS: A total of 26 patients started and five patients completed the total protocol. INTERVENTIONS: The treatment protocol was divided into three parts: (i) 1 alpha(OH)D3 administered intravenously for > 300 days; then (ii) 1 alpha(OH)D3 administered orally for 100 days, followed by (iii) 1 alpha(OH)D3 administered intravenously again for another 100 days. 1 alpha(OH)D3 was given three times a week at the end of each dialysis. MAIN OUTCOME MEASURES: Intact PTH, N- and C-terminal PTH. RESULTS: Intact PTH levels were significantly (P < 0.0001) suppressed by 90.4 +/- 3.3% after 56 days of intermittent intravenous 1 alpha(OH)D3 treatment. This degree of suppression remained stable during the following period of oral treatment and did not change further when intravenous treatment was reinstituted. The circulating levels of intact PTH and N- and C-terminal iPTH were not influenced by the administered route of 1 alpha(OH)D3. CONCLUSIONS: Intravenous 1 alpha(OH)D3 treatment of the secondary HPT in dialysis patients can safely be changed to oral treatment at the time when optimal suppression of PTH has been achieved. SN - 0954-6820 UR - https://www.unboundmedicine.com/medline/citation/8774390/Intermittent_intravenous_followed_by_intermittent_oral_1_alpha_OH_D3_treatment_of_secondary_hyperparathyroidism_in_uraemia_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0954-6820&amp;date=1996&amp;volume=239&amp;issue=4&amp;spage=353 DB - PRIME DP - Unbound Medicine ER -