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FACTORS INFLUENCING THE RESPONSE TO lα‐HYDROXYVITAMIN D 3 IN PATIENTS WITH RENAL BONE DISEASE
Author(s) -
KANIS J. A.,
RUSSELL R. G. G.,
NAIK R. B.,
EARNSHAW M.,
SMITH R.,
HEYNEN G.,
WOODS C. G.
Publication year - 1977
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1977.tb03362.x
Subject(s) - osteomalacia , medicine , osteitis , parathyroid hormone , vitamin d and neurology , osteitis fibrosa cystica , bone disease , alkaline phosphatase , endocrinology , calcium , histology , kidney disease , gastroenterology , hyperparathyroidism , surgery , osteoporosis , chemistry , osteomyelitis , biochemistry , enzyme
SUMMARY Twenty‐three patients with bone disease and chronic renal failure were treated for periods of 4–28 months with lα‐hydroxyvitamin D 3 (1α‐OHD 3 ). Improvements in bone histology were consistently seen in patients with features both of osteitis fibrosa and osteomalacia but were not invariably observed in patients with osteitis fibrosa or osteomalacia alone (37 and 50% improved respectively). Several factors influencing the outcome of treatment were assessed on the basis of histological responses in bone. A low level of plasma calcium before treatment, rather than the dose of lα‐OHD 3 tolerated, was the major detectable factor which favourably affected the histological outcome. Other factors examined, including initial plasma concentrations of phosphate, immunoreactive parathyroid hormone and alkaline phosphatase, and treatment with haemodialysis or dietary supplements of calcium did not apparently influence the response.