[Influence of alphacalcidole on selected markers of the bone turnover in hemodialysed patients with secondary hyperparathyroidism].

In 19 chronically hemodialysed patients (11M + 8F, mean age 52 +/- 15 yrs) with secondary hyperparathyroidism (sHP), selected markers of bone turnover in the course of pulsative treatment with alphacalcidol were evaluated. Alphakalcidol was given 3 times per week after hemodialysis. Every 3-rd month of therapy we measured serum concentration of procollagen type I carboxy-terminal propeptide PICP as a marker of bone formation as well as carboxy-terminal telopeptide type I collagen ICTP and iPTH as markers of bone resorption. The results were as follows. During 12 months of controlled treatment of sHP with alphacalcidol, statistically significant decrease of serum iPTH (from 393 +/- 145 pg/ml to 246 +/- 172 pg/ml) with simultaneous increase of serum PICP (from 235 +/- 168 mg/L to 414 +/- 168 mg/L) were obtained. Serum ICTP levels, although significantly increased in comparison to normal values, did not change under influence of alphacalcidol therapy. The mean weakly dosis of alphacalcidol of 2.27-2.39 mg successfully suppressed process of bone resorption evaluated by iPTH giving predominance to bone formation expressed by PICP. Serum levels of ICTP appeared to be of no value in monitoring treatment efficacy of alphacalcidol in hemodialysed patients with secondary hyperparathyroidism.