You are here

Home » Content

KRONİK HEMODİYALİZ HASTALARINDA ARALIKLI ORAL VE İNTRAVENÖZ 1.25 (OH)2 CHOLECALCIFEROL (CALCITRIOL) TEDAVİSİ

INTERMITTENT ORAL AND INTRAVENOUS 1.25 (OH), CHOLECALCIFEROL (CALCITRIOL) TREATMENT IN CHRONIC HEMODIALYSIS PATIENTS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1998

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Intermittent intravenous and oral Calcitriol have been shown to be effective in the treatment of secondary hyperparathyroidism in chronic hemodialysis (CHD) patients. We exomined the time course of serum levels of Intact Parathyroid Hormone (I-PTH) and size of parathyroid glands in CHD patients with intermittent oral (ORC, n=15) and intravenous calcitriol (IVC, n=17) therapy for 16 weeks. Calcitriol (1 microgram/3 timer per week) was given at the given at the end of each dialysis. At the end of the study, serum I-PTH levels decreased significantly from 235.5±58.3 to I38±54 pg/ml in IVC group and from 243.5±66.5 to 81.4+37.2 pg/ml in ORC group. On the other hand, parathyroid gland sizes remained constant after each treatment modalities. We concluded that both IVC and ORC tretments result in a significant decrement in serum levels of I-PTH in CHD patients with secondary hyperparathyroidism (Schpt); but there was no difference between IVC and ORC for the PTH suppressive-effect. However, no size reduction of parathyroid glands was demonstreated with both treatments.
Bookmark/Search this post with
Abstract (Original Language): 
Kronik hemodiyaliz (CHD) hastalarmdaki sekonder hiperparatiroidizm tedavisinde aralıklı intravenöz (IVC) ve oral calcitriol (ORC) uygulamasının etkili olduğu gösterilmiştir. Biz, 16 haftalık aralıklı intravenöz ve oral calcitriol tedavisiyle CHD hastalarmdaki paratiroid gland boyutları ve serum intakt-Parathormon (I-PTH) düzeylerinde olan değişimi incelendi. Calcitriol (lmikrogram/haftada 3 kez) her diyalizin sonunda verildi. Çalışma sonunda serum I-PTH düzeyleri IVC grubunda 235.5±58.3'den 138±54pg/ml'ye, ORC grubunda ise 243.5±66.5den 81.4+3 7.2pg/ml 'ye geriledi. Paratiroid gland boyutları ise her bir tedavi grubunda anlamlı bir değişim göstermedi. Bu çalışmada her iki tedavi şeklinin sekonder hiperparatiroidizm li CHD hastalarında serum I-PTH düzeylerini belirgin olarak azalttığı ancak bu PTH baskılayıcı etki açısından tedavi grupları arasında bir fark olmadığı sonucuna vardık. Bununla birlikte paratiroid glandların boyutlarında her iki tedavi yöntemiyle de herhangi bir gerileme gösterilemedi.
FULL TEXT (PDF): 
PDF icon pdf_tndt_229.pdf
  • 4
212-216
  • Turkish

REFERENCES

References: 

1. Malluche H, Faugere MC: Renal bone disease 1990: An unmet challenge for the nephrologist. Kidney Int 1990;38:193-211.
2. Epstein FH, Hruska KA, Teitelbaum SL: Renal osteodystrophy. NEJM 1995;20:166-174.
3. Slatopolsky E, Delmez AJ: Pathogenesis of secondary hyperparatiroidism. Am J Kidney Dis 1994;23
(Fesruary No.2):229-236.
4. Llach F, Massry SG, Koffler A, Malluche MIL Singer
FR, Brickman AS, Kurokawa K: Secondary hyperparathyroidism in eraly renal failure: Role of phosphate retention . Kidney Int 1977; 12:459.
5. Llach F, Massry SG: On the mechanism of secondary hyperparathyroidism in moderate renal failure, J Clin
Endocrinol Metab 1985;61:601-606.
6. Silver J, Naveh-Many T, Mauer H, Schmeizer HJ, Popovtzer MM: Regulation by vitamin D metabolies of parathyroid hormone gene transcription in vivo by the
rat. .1 Clin Invest 1986;78:1296-1301.
7. Cantley LK, Russell J, Lettieri D, Sherwood LM: 1.25-
dihydroxyvitamin D3 suppresses parathyroid hormone secretion from parathyroid cells in tissue culture.
Endocrinology 1985;117:2114-2119.
8. Goodman WG, Coburn JW: The use of 1.25 (OH)2D3 in
early renal failure. Annu Rev Med 1992;43:227-237.
9. Delmez JA, Tindira C, Grooms P, Dusso A, Windus DW, Slatopolsky E: Parathyroid hormone suppression by intravenous 1.25-dihydroxyvitamin D. J Clin Invest 1989;83:1349-1355.
10. Andress DL, Norris KC, Coburn JW, Slatopolsky EA,
Sherrard DJ: Intravenous calcitriol in the treatment of refractory osteitis fibrosa of chronic renal failure.
NEJM 1989;321 (No 5):274-279.
11. Cannella G, Bonucci E, Rolla D, Ballanti P, Moricro E, De Grandi R, Augeri C, Claudiani F, Di Maio G: Evidence of healing of secondary hyperparathyroidism in chronically hemodialyzed uremic patients treated with long-term intravenous calcitriol. Kidney Int 1994;46:1124-1132.
12. Rodriguez M, Felsenfeld AJ, Williams C, Pcderson JA, Llach F: The effect of long term intravenous calcitriol administration on parathyroid function in hemodialysis
patients. J Am Soc Nephrol 1991;7:141-145.
13. Slatopolsky E, Weerts C, Thielan J, Horst R, Harter H,
Martin KJ: Marked suppression of secondary hyperparathyroidism by intravenous administration of 1.25-dihydroxycholecalciferol in uremic patients. J Clin
Invest 1984;74:2136-2143.
14. Hyodo T, Ono K, Koumi T, Ueda M, Miyagawa I. Kodani K, Doi S, Ishibashi M, Morita T: Can oral 1.25 (OH)2D3 pulse therapy reduce parathyroid hyperplasia.
Nephron 1991;59:171-172.
15. Martin KJ, BaJlal HS, Domoto DT, Blalock S. Weindel M: Pulse oral calcitriol for the treatment of hypoparathyroidism in patients on continuous ambulatory peritoneal dialysis: Preliminary observations. Am J Kidney Dis 1992; 19 (June No 6):540-545
16. Muramoto H, Haruki K, Yoshimura A, Mimo N, Oda K, Tofuku Y: Treatment of refractory hyperparathyroidism in patients on hemodialysis by intermittent oral
administratiion of 1.25(OH)2D3 Nephron 1991:58:288¬294.
17. Ritz E, Klaus G, Mehls O, Hinderer J: Is intermittent oral calcitriol safe and effective in renal secondary hyperparathyroidism? Lancet 1991 ;337 (March 30):800-801.
18. Tsukamoto Y, Nomura M, Takahashi Y, Takagi Y, Yoshida A, Nagaoka T, Togashi K, Kikawada R, Marumo F: The "oral 1.25(OH),vitaminD3 pulse therapy" in hemodialysis patients with severe secondary hyperparathyroidism. Nephron 1991;57:23-28.
19. Gallieni M, Brancaccio D, Padovese P, Rolla D. Bedani P, Colantonio G, Bronzieri C, Bagni B, Tarolo G: Low-dose intravenous calcitriol treatment of secondary hyperparathyroidism in hemodialysis patients. Kidney Int 1992;42:1191-1198.
20. Sprague SM, Moe SM: Safety and efficacy oof long term treatment of secondary hyperparatiroidism by low dose intravenous calcitriol. Am .1 Kidney Dis
1992; I9:(june No 6): 532-539.
21. Szabo A, Merke J, Beier E, Mall G, Ritz E: 1.25(OH)2vitaminD3 inhibits parathyroid cell proliferation in experimental uremia. Kidney Int 1989;35:1049-1056
22. Quarles LD, Yohay DA, Carroll BA, Spritzer CE,
Minda SA, Bartholomay D, Lobaugh BA: Prospective trial of pulse oral versus intravenous calcitriol treatment of hyperparatiroidism in ESRD. Kidney Int 1994;45:1710-1721
23. Fisher ER, Harris DCH: Comparison of intermittent oral and intravenous calcitriol in hemodialysis patients with secondary hyperparathyroidism. Clin Nephrol
1993;40(No4):216-220.
24. Fukııda N, Tanaka H, Tominaga Y, Fukagawa M. Kurokawa K, Seino Y: Decreased 1.25-dihydroxyvitaminD-, receptor densityis associated with a more severe form of parathyroid hyperplasia in chronic uremic patients. J Clin Invest 1993;92:1436-
1443.

Thank you for copying data from http://www.arastirmax.com