Limitations of pulse oral calcitriol therapy in continuous ambulatory peritoneal dialysis patients.
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Bechtel U, Mucke C, Feucht HE, Schiffl H, Sitter T, Held E
Limitations of pulse oral calcitriol therapy in continuous ambulatory peritoneal dialysis patients.
Am J Kidney Dis. 1995 Feb;25(2):291-6.
- PubMed ID
- 7847357 [ View in PubMed]
- Abstract
Calcitriol is increasingly used for therapy of secondary hyperparathyroidism in patients with end-stage renal disease. Its therapeutic efficacy, however, often has been limited by the associated increase in intestinal calcium and phosphorus absorption. Previous studies reported that these side effects could be avoided by intermittent administration of calcitriol in high doses, subsequently referred to as pulse therapy. The present study was designed to investigate pulse oral calcitriol therapy in a patient subgroup especially susceptible to the development of hypercalcemia and hyperphosphatemia under standard continuous calcitriol treatment. We examined 15 peritoneal dialysis patients with moderate degrees of hyperparathyroidism (intact parathyroid hormone [iPTH] levels, 150 to 903 pg/mL) ingesting between 1.5 and 6 g of calcium salts as the sole phosphate binders. Treatment consisted of 0.5 microgram calcitriol twice weekly. Eight of these patients had been previously converted to low calcium dialysate to tolerate the necessary doses of phosphate-binding calcium salts. During the study period, comprising 8 pretreatment weeks and 8 weeks of therapy, dialysates and doses of calcium salts were not changed, so that only calcitriol influenced the determined parameters. As expected, iPTH levels decreased rapidly in all patients (P < 0.0001). However, within 4 weeks of treatment a marked increase in calcium phosphorus products was observed (P < 0.0001). Overt hypercalcemia developed in five patients. We concluded that pulse oral calcitriol has to be carefully monitored in peritoneal dialysis patients receiving high doses of calcium salts because of the increased risk for hypercalcemia and hyperphosphatemia.
DrugBank Data that Cites this Article
- 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