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Intermittent intravenous followed by intermittent oral 1α(OH)D 3 treatment of secondary hyperparathyroidism in uraemia
Author(s) -
BRANDI L.,
DAUGAARD H.,
EGSMOSE C.,
TVEDEGAARD E.,
KJÆRULFF NIELSEN P.,
OLGAARD K.
Publication year - 1996
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.1996.469810000.x
Subject(s) - medicine , secondary hyperparathyroidism , dialysis , hyperparathyroidism , oral administration , alpha (finance) , parathyroid hormone , intravenous therapy , route of administration , endocrinology , urology , gastroenterology , surgery , calcium , construct validity , patient satisfaction
Brandi L, Daugaard H, Egsmose C, Tvedegaard E, Kjærulff Nielsen P, Olgaard K (Medical Department P, Division of Nephrology, Rigshospitalet, University of Copenhagen, Denmark). Intermittent intravenous followed by intermittent oral 1α(OH)D 3 treatment of secondary hyperparathyroidism in uraemia. J Intern Med 1996; 239: 353–60. Objectives . To examine whether intermittent oral 1α(OH)D 3 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 1α(OH)D 3 . Simultaneously, the effect of the different routes of administration of 1α(OH)D 3 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) 1α(OH)D 3 administered intravenously for >300 days; then (ii) 1α(OH)D 3 administered orally for 100 days, followed by (iii) 1α(OH)D 3 administered intravenously again for another 100 days. 1α(OH)D 3 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 1α(OH)D 3 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 1α(OH)D 3 . Conclusions . Intravenous 1α(OH)D 3 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.