Guidelines for dosing of intravenous calcitriol in dialysis patients with hyperparathyroidism

Intravenous calcitriol has not been used appropriately in the treatment of secondary hyperparathyroidism (HPT) of dialysis patients. Initiation of calcitriol therapy late in severe HPT and inappropriate dosing of calcitriol are common causes of inadequate use of calcitriol. This paper gives general guidelines on the use of intravenous calcitriol and emphasizes the importance of appropriate control of serum phosphorous. The issue of dosing of calcitriol commensurate with the severity of the HPT are highlighted as essential for the complexion of a successful therapeutic attempt. In addition, maintenance dose of calcitriol varies according to the severity of the HPT at the time of initiation of therapy.