Effect of oral administration with active vitamin D on the pulse treatment of secondary hyperparathyroidism in patients with end stage renal failure

AIM To observe the therapeutic effect and safety of oral administration with active vitamin D on the pulse treatment of secondary hyperparathyroidism in patients with end stage renal failure.METHODS From April,2007 to October,2008,91 patients with secondary hyperparathyroidism caused by end stage renal failure were enrolled in the study.The calcium concentration in dialysate was 1.5 mmol·L~(-1),and the patients received oral administration of active vitamin D.The end-point parameter was iPTH≤300 ng·L~(-1) or duration of treatment lasted for 20 weeks.The dose of active vitamin D was 1-1.5μg,twice a week,when the concentration of iPTH varied between 300 and 600 ng·L~(-1). The dose of active vitamin D was 1.5-2.0μg,twice a week,when 300 iPTH≤600 ng·L~(-1).The dose of active vitamin D was 2.0-2.5μg,twice a week,when iPTH 1 000 ng·L~(-1).The blood concentrations of iPTH,calcium, phosphate and alkaline phosphatase(ALP) before treatment and 4,8,20 weeks after treatment were measured,and the adverse drug reactions were monitored.RESULTS Compared with that before treatment,the concentration of iPTH after treatment decreased significantly(P0.01),and the percentage of patients reaching end-point parameter at the 4th week accounted for 45.1%.During the course of treatment,the blood concentration of calcium showed no significant increase and the blood concentration of phosphate decreased significantly after treatment.There was no significant difference in alkaline phosphatase concentration and adverse drug reaction was mild.CONCLUSION The therapeutic effects of oral administration with active vitamin D in patients with secondary hyperparathyroidism are found to be remarkable and safe, especially for the early-stage pulse treatment.