Comparison of intermittent and continuous oral administration of calcitriol in dialysis patients: a randomized prospective trial.
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Herrmann P, Ritz E, Schmidt-Gayk H, Schafer I, Geyer J, Nonnast-Daniel B, Koch KM, Weber U, Horl W, Haas-Worle A, et al.
Comparison of intermittent and continuous oral administration of calcitriol in dialysis patients: a randomized prospective trial.
Nephron. 1994;67(1):48-53.
- PubMed ID
- 8052367 [ View in PubMed]
- Abstract
Intermittent bolus administration of calcitriol--i.e., 1,25-dihydroxycholecalciferol or 1,25-(OH)2D3--is highly efficacious in dialysis patients. In experimental studies, intermittent administration of calcitriol is superior to continuous administration in suppressing preproparathyroid hormone (PTH) mRNA and circulating PTH concentrations. In a randomized, prospective, open multicenter trial 45 dialysis patients with elevated 1,84-iPTH (> or = 20 pmol/l, normal 1-6 pmol/l) levels were randomly allocated to daily administration of 0.75 microgram calcitriol (continuous) or twice weekly administration (intermittent); the two protocols provided an identical total weekly doses of 5.25 micrograms calcitriol. Patients were dialyzed with a dialysate Ca concentration of 1.75 mmol/l and had oral CaCO3 or Ca acetate. 1,84-iPTH (immunoradiometric assay) and serum Ca and Pi levels were measured weekly. At the beginning of the study, the median 1,84-iPTH value was 37 pmol/l (range 20-115) in the intermittent versus 36 pmol/l (range 21-72) in the continuous calcitriol group. After 2 weeks, the median 1,84-iPTH level was 18.5 pmol/l (range 1.4-106) versus 18 pmol/l (range 1.2-48). After 12 weeks, 11 of 21 of the patients in the intermittent and 18 of 24 patients in the continuous group had reached the treatment goal, i.e., 1,84-iPTH < or = 10 pmol/l without hypercalcemia or hyperphosphatemia. There were seven episodes of hypercalcemia (> 2.7 mmol/l) in the intermittent versus two in the continuous group; the mean peak Ca level was 2.8 mmol/l (range 2.76-3.0) versus 2.9 mmol/l (range 2.74-3.06). There were 21 versus 17 episodes, respectively, of hyperphosphatemia (> 2.2 mmol/l).
DrugBank Data that Cites this Article
- Pharmaco-transcriptomics
Drug Drug Groups Gene Gene ID Change Interaction Chromosome Calcitriol Approved Nutraceutical PTH 5741 downregulated Calcitriol results in decreased expression of PTH mRNA 11p15.3 - Pharmaco-proteomics
Drug Drug Groups Gene Gene ID Change Interaction Chromosome Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3