Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2013
[Effect of calcitriol on secondary hyperparathyroidism].
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Xu Hui, Zhang Jin, Cheng Xiaomiao, Zhou Qiaoling
Аннотация
OBJECTIVE: To investigate the calcium-phosphate metabolic condition in maintenance hemodialysis patients with chronic kidney disease (CKD), and to observe the effect of large dose calcitriol on secondary hyperparathyroidism (SHPT).
METHODS: We tested and compared the serum levels of calcium, phosphate, intact parathyroid hormone (iPTH), and alkaline phosphatase (AKP) in hemodialysis patients at different hemodialysis time (Group A with hemodialysis period ≤3 years and Group B with hemodialysis period >3 years). We also detected those indexes before and after treating SHPT with large dose calcitriol. Twenty SHPT patients were divided into Group I (enlargement of parathyroid gland or nodule detected by color Doppler ultrasound) and Group II (normal parathyroid gland detected by color Doppler ultrasound).
RESULTS: In the maintenance hemodialysis patients, the serum phosphate was (2.11±0.38) mmol/L and iPTH was (581.11±487.75) pg/mL. The serum level of iPTH in Group B was higher than that in Group A [(828.13±690.39) pg/mL vs (477.94±324.73) pg/mL, P<0.001]. In Group I, the serum level of iPTH [before vs after: (2471.7±898.3) pg/mL vs (2510.4±825.7) pg/mL] and AKP [before vs after: (524.2±18.8)U/L vs (511.3±19.3)U/L] did not change after the treatment of large dose calcitriol (P>0.05). In Group II, the serum level of iPTH [before vs after: (1358.5±302.8) pg/mL vs (369.3±43.4) pg/mL, P<0.001] and AKP [before vs after: (565.9±23.9)U/L vs (234.8±21.1)U/L, P<0.001] decreased significantly after the treatment of large dose calcitriol.
CONCLUSION: Patients with longer time of hemodialysis have a higher level of iPTH. Large dose calcitriol can improve the clinical syndrome of SHPT, and decrease the level of iPTH and AKP in SHPT patients with normal parathyroid gland.
METHODS: We tested and compared the serum levels of calcium, phosphate, intact parathyroid hormone (iPTH), and alkaline phosphatase (AKP) in hemodialysis patients at different hemodialysis time (Group A with hemodialysis period ≤3 years and Group B with hemodialysis period >3 years). We also detected those indexes before and after treating SHPT with large dose calcitriol. Twenty SHPT patients were divided into Group I (enlargement of parathyroid gland or nodule detected by color Doppler ultrasound) and Group II (normal parathyroid gland detected by color Doppler ultrasound).
RESULTS: In the maintenance hemodialysis patients, the serum phosphate was (2.11±0.38) mmol/L and iPTH was (581.11±487.75) pg/mL. The serum level of iPTH in Group B was higher than that in Group A [(828.13±690.39) pg/mL vs (477.94±324.73) pg/mL, P<0.001]. In Group I, the serum level of iPTH [before vs after: (2471.7±898.3) pg/mL vs (2510.4±825.7) pg/mL] and AKP [before vs after: (524.2±18.8)U/L vs (511.3±19.3)U/L] did not change after the treatment of large dose calcitriol (P>0.05). In Group II, the serum level of iPTH [before vs after: (1358.5±302.8) pg/mL vs (369.3±43.4) pg/mL, P<0.001] and AKP [before vs after: (565.9±23.9)U/L vs (234.8±21.1)U/L, P<0.001] decreased significantly after the treatment of large dose calcitriol.
CONCLUSION: Patients with longer time of hemodialysis have a higher level of iPTH. Large dose calcitriol can improve the clinical syndrome of SHPT, and decrease the level of iPTH and AKP in SHPT patients with normal parathyroid gland.