Abstract
We attempted to confirm whether intermittent high-dose oral 1,25-dihydroxyvitamin D3 (PULSE) suppressed parathyroid hormone (PTH) secretion, inhibited parathyroid cell proliferation, and increased bone mass in uremic patients (Pts). Twenty two long-term hemodialysis Pts with secondary hyperparathyroidism were given 3.4±0.8µg 1,25 dihydroxyvitamin D3 twice a week for 9.5±3.3 M. The size of parathyroid gland (PT) was estimated by echography and computed tomography every 3 months. Bone mineral density of the radius (BAD) was measured by single photon absorptiometer (Norland SPA 26).
Findings were:
- | Before PULSE | 6 months | P-value |
Ca (mg/dl) | 9.96± 1.18 | 11.15± 1.61 | <0.001 |
P (mg/dl) | 5.17± 1.83 | 5.78 ± 1.11 | n.s. |
Alk-Pase (IU) | 373 ± 385 | 167± 79 | <0.005 |
HS-PTH (ng/ml) | 49.9±31.5 | 8.01±3.83 | <0.005 |
I-PTH (pg/ml) | 563± 453 | 165 ± 101 | <0.005 |
The volumes of 22 PT detected by echography in 11 Pts before and after PULSE were 363±385 and 434±462cmm (n.s.), respectively. In 6 Pts before the PULSE therapy began and after 11.OM of PULSE, The BAD values were measured in 6 Pts before and after 11.OM of PULSE. They were 0.388±0.115 and 0.398±0.093 g/cm2 (n.s.), respectively.
We conclude that at this dose schedule, PULSE suppresses PTH secretion, but does not decrease PT size or increase the bone mass.
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Akiba, T., Ando, R., Shioyama, Ki. et al. Intermittent high-dose oral 1,25-dihydroxyvitaimin D3 for secondary hyperparathyroidism in hemodialysis patients. J Bone Miner Metab 9, 49–55 (1991). https://doi.org/10.1007/BF02374907
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DOI: https://doi.org/10.1007/BF02374907