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No difference between alfacalcidol and paricalcitol in the treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized crossover trial
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No difference between alfacalcidol and paricalcitol in the treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized crossover trial
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No difference between alfacalcidol and paricalcitol in the treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized crossover trial
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Journal Article
No difference between alfacalcidol and paricalcitol in the treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized crossover trial
2011
Overview
Alfacalcidol and paricalcitol are vitamin D analogs used for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease, but have known dose-dependent side effects that cause hypercalcemia and hyperphosphatemia. In this investigator-initiated multicenter randomized clinical trial, we originally intended two crossover study periods with a washout interval in 86 chronic hemodialysis patients. These patients received increasing intravenous doses of either alfacalcidol or paricalcitol for 16 weeks, until parathyroid hormone was adequately suppressed or calcium or phosphate levels reached an upper threshold. Unfortunately, due to a period effect, only the initial 16-week intervention period for 80 patients was statistically analyzed. The proportion of patients achieving a 30% decrease in parathyroid hormone levels over the last four weeks of study was statistically indistinguishable between the two groups. Paricalcitol was more efficient at correcting low than high baseline parathyroid hormone levels, whereas alfacalcidol was equally effective at all levels. There were no differences in the incidence of hypercalcemia and hyperphosphatemia. Thus, alfacalcidol and paricalcitol were equally effective in the suppression of secondary hyperparathyroidism in hemodialysis patients while calcium and phosphorus were kept in the desired range.
Publisher
Elsevier Inc,Nature Publishing Group,Elsevier Limited
Subject
/ Adult
/ Aged
/ Biological and medical sciences
/ Ergocalciferols - adverse effects
/ Ergocalciferols - therapeutic use
/ Female
/ Humans
/ Hydroxycholecalciferols - adverse effects
/ Hydroxycholecalciferols - therapeutic use
/ Hyperparathyroidism, Secondary - drug therapy
/ Male
/ Nephrology. Urinary tract diseases
/ Non tumoral diseases. Target tissue resistance. Benign neoplasms
/ Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)
