Buradasınız

Anasayfa » Content

ÇOCUKLARDA RENAL OSTEODİSTROFİDE ORAL PULSE KALSİTRİOL TEDAVİSİ

ORALPULSE CALCITRIOLTHERAPY IN CHILDREN WITH RENAL OSTEODYSTROPHY

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: The aim of this study was to determine the effects and safety of oral pulse calcitriol therapy in patients with renal osteodystrophy (ROD) refractory to the conventional oral vitamin D therapy. Materials and methods: After baseline determination of serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), urea, creatinine, intact parathyroid hormone (iPTH), osteocalcin, calcitriol levels and parathyroid gland ultrasonography, oral pulse calcitriol therapy was started at doses of 2 μg, three times a week, and all these parameters were followed up for a period of 4-6 months. Results: Serum iPTH levels measured in the 2nd and 6th months were significantly lower than basal serum iPTH levels (p<0.05). Although basal and post-treatment serum osteocalcin and calcitriol levels were in the normal range, increment in serum calcitriol levels and decrement in serum osteocalcin levels were found statistically significant (p<0.05). The changes of serum Ca, P, CaxP levels were not found statistically significant during the study protocol; however, serum ALP levels declined significantly (p<0.05). Conclusion: Our results indicate that oral pulse calcitriol therapy is well tolerated and this treatment can suppress iPTH levels without increasing hypercalcaemia risk in refractory secondary hyperparathyroidism in patients with chronic renal failure.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Bu çal›flman›n amac›, konvansiyonel oral D vitamini tedavisine dirençli renal osteodistrofili çocuklarda oral “pulse” kalsitriol tedavisinin etkinli¤ini de¤erlendirmekti. Gereç ve yöntem: Bazal serum kalsiyum, fosfor, alkalen fosfataz, üre, kreatinin, intakt paratiroid hormon (iPTH), osteokalsin, kalsitriol düzeyleri için örnek al›nd›ktan ve paratiroid bezi ultrasonografisi yap›ld›ktan sonra haftada üç kez, 2 μg oral pulse kalsitrioil tedavisi baflland› ve tüm parametreler 4-6 ay süreyle izlendi. Bulgular: ‹kinci ve 6. ayda ölçülen serum iPTH düzeyleri bazal düzeye göre anlaml› olarak düfltü (p<0,05). Bazal ve tedavi sonras› serum osteokalsin ve kalsitriol düzeyleri normal s›n›rlarda olmas›na karfl›n, serum kalsitriol düzeyindeki art›fl, serum osteokalsin düzeyindeki azalma istatistiksel olarak anlaml›yd› (p<0,05). Serum Ca, P, CaxP düzeylerindeki de¤ifliklikler istatistiksel olarak anlaml› bulunmad›; ancak alkalen fosfataz düzeyi anlaml› olarak düfltü (p<0,05). Sonuç: Oral “pulse” kalsitriol tedavisi iyi tolere edilmektedir ve bu tedavi kronik böbrek yetersizli¤i olan sekonder hiperparatiroidizmli çocuklarda serum iPTH düzeyini hiperkalsemi riskine yol açmaks›z›n bask›layabilmektedir.
FULL TEXT (PDF): 
PDF icon arastirmax-cocuklarda-renal-osteodistrofide-oral-pulse-kalsitriol-tedavisi.pdf
  • 1
5-9
  • English

REFERENCES

References: 

1. Bilge I, Emre S, fiirin A, Nay›r A, Öktem F. Çocuk hemodiyaliz
hastalar›nda dirençli sekonder hiperparatiroidizm tedavisinde
intravenöz kalsitriol uygulamas›. ‹st T›p Fak Mecmuas› 2000;
63:76-83.
2. Cano F, Delucchi A, Wolff E, Rodriguez E, Fuentes A. Calcitriol
oral pulse therapy in children with renal osteodystrophy. Pediatr
Nephrol 1995; 9:606-608.
3. Coizon BD, Salusky ID. Renal Osteodystrophy. In: Avner ED,
Harmon WE, Niaudet P (eds). Pediatric Nephrology. Lippincott,
Williams, Wilkins. Philadelphia, USA, 5th ed., 2004; pp 1347-
1373.
4. Dahl NV, Foote EF. Pulse oral calcitriol therapy for renal osteodystrophy.
ANNAJ 1997; 25:550-555.
5. Delmez JA, Slatopolsky E. Recent advances in the pathogenesis
and therapy of uremic secondary hyperparathyroidism. J Clin
Endocrinol Metab 1991; 72:735-739.
6. Fukagawa M, Kitaoka M, Yi H, Fukuda N, Matsumoto T, Ogata
E, Kurokawa K. Serial evaluation of parathyroid size by ultrasonography
is another useful marker for the long-term prognosis
Oral pulse calcitriol therapy in renal osteodystrophy
‹stanbul T›p Fakültesi Dergisi Cilt / Volume: 69 • Say› / Number: 1 • Y›l/Year: 2006
- 8 -
of calcitriol pulse therapy in chronic dialysis patients. Nephron
1994; 68:221-228.
7. 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
haemodialysis patients. Kidney Int 1992; 4:1191-1198.
8. Malberti F, Surian M, Cosci P. Effect of chronic intravenous calcitriol
on parathyroid function and set point of calcium in dialysis
patients with refractory secondary hyperparathyroidism.
Nephrol Dial Transplant 1992; 7:822-828.
9. Martinez ME, Selgas R, Miguel JL, Balaguer G, Cabezudo
MJC. Osteocalcin levels in uremic patients. Nephron 1991;
59:429-433.
10. Moe SM. Renal osteodystrophy. In: Pereira BJG, Sayegh MH,
Blake P (ed). Chronic Kidney Disease, Dialysis, Transplantation.
Elsevier, Saunders. Philadelphia, USA, 2nd ed., 2005; pp 136-
157.
11. Muramoto H, Haruki K, Yoshimura A, Mimo N, Oda K, Tofuku
Y. Treatment of refractory hyperparathyroidism in patients on
haemodialysis by intermittent oral administration of 1,25 (OH)2
vitamin D3. Nephron 1991; 58:288-294.
12. Quarles LD, Davidai GA, Schwab SJ, Bartholomay DW, Lobaugh
B. Oral calcitriol and calcium: efficient therapy for uremic
hyperparathyroidism. Kidney Int 1988; 34:840-844.
13. Quarles LD, Yohay YD, Carroll BA, Spritzer CE, Minda SA,
Bartholomay D, Lobaugh BA. Prospective trial of pulse oral versus
intravenous calcitriol of hyperparathyroidism in ESRD. Kidney
Int 1994; 45:1710-1721.
14. Slatopolsky E, Weerts J, Thielan J, Horst R, Harter H, Martin K.
Marked suppression of secondary hyperparathyroidism by intravenous
1,25-dihydroxy-cholecalciferol in uremic patients. J Clin
Invest 1984; 74: 2136-2143.
15. Sperschneider H, Humbsch K, Abendroth K. Oral calcitriol pulse
therapy in hemodialysis patients. Med Klin 1997; 92:597-603.
16. Tsukomoto Y, Nomura M, Marumo F. Pharmacological parathyroidectomy
by oral 1,25 (OH)2 D3 pulse therapy. Nephron
1989; 51:130-131.
17. Tsukomoto Y, Nomuro M, Takahashi Y, Takagi Y, Yoshida A,
Nagaoka T, Togashi K, Kikawada R, Maromo F. The oral 1,25
(OH)2 D3 pulse therapy in haemodialysis patients with severe
secondary hyperparathyroidism. Nephron 1991; 57:23-28.
18. Tsukamoto Y. Vitamin D therapy in renal osteodystrophy. Clin
Calcium 2004; 14:21-26.
19. Türk S, Akbulut M, Y›ld›z A, Gürbilek M, Gönen S, Tombul Z,
Yeksan M. Comparative effect of oral pulse and intravenous calcitriol
treatment in hemodialysis patients. Nephron 2002;
90:188-194.

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