ISSN:
1432-1041
Keywords:
Vitamin D
;
1-alpha-hydroxycholecalciferol
;
uremia
;
renal osteodystrophy
;
calcium metabolism
Source:
Springer Online Journal Archives 1860-2000
Topics:
Chemistry and Pharmacology
,
Medicine
Notes:
Summary Twentytwo adult patients with chronic renal insufficiency received long-term treatment (mean 15.4 months) with 1-alpha-hydroxycholecalciferol (1α(OH)D3), a synthetic vitamin D analogue. Before treatment 73% of the patients were hypocalcemic, intestinal calcium absorption was reduced in 82%, serum immunoreactive parathyroid hormone (i-PTH) was increased in 86% and serum alkaline phosphatases were increased in 50% of them. Furthermore, 91% of the patients had generalized scintigraphic bone changes indicative of renal osteodystrophy, 59% had reduced bone mineral content (BMC), 32% had radiographic bone changes and 27% had clinical symptoms. During treatment all patients became normocalcemic within one month; intestinal calcium absorption increased to reach normal values; i-PTH declined significantly, but remained elevated in 50% of patients; serum alkaline phosphatases declined significantly and became normal in all except 2 patients; bone scintigraphy and/or radiography showed considerable improvement in 4 patients; the accelerated bone loss in uremia ceased and bone pain disappeared in 5 of the 6 patients who had had this symptom. Nineteen short-lasting acute hypercalcemic episodes were recorded during treatment. In all cases normocalcemia was re-established within 72 hours after discontinuing the drug. No side-effects were observed apart from hypercalcemia. The present data demonstrate the long-term beneficial effects of 1 α(OH)D3 in improving clinical symptoms and reversing several biochemical and skeletal abnormalities in patients with chronic renal failure.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00566316
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