ORALPULSE CALCITRIOLTHERAPY IN CHILDREN WITH RENAL OSTEODYSTROPHY
Journal Name:
- İstanbul Tıp Fakültesi Dergisi
Keywords (Original Language):
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.
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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.
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