关键词: 帕立骨化醇, 起始剂量, 继发性甲状旁腺功能亢进, 血液透析

Abstract:

Abstract Objective: To observe the efficacy and safety of paricalcitol in treatment of secondary hyperparathyroidism (SHPT) in maintenance hemodialysis (MHD) patients at a medium initial dose of 0.06-0.08ug/kg. Methodology: Eleven MHD patients (8 males and 3 females) were enrolled to receive intravenous injection of paricalcitol thrice weekly for treatment of SHPT, with inclusion criteria as follows: maintenance on HD>3 months, serum intact parathyroid hormone (iPTH) ≥600 pg/ml, serum Ca (calcium) ≤2.6 mmol/l, and Ca × phosphorus (P) ≤ 65 mg2/dl2. During 12-weeks’ follow-up, serum Ca and P were measured per 2 weeks and iPTH was measured per 4 weeks. Dose of paricalcitol was adjusted according to the measurements results. Results: The baseline levels of iPTH, Ca, and P were 1087 (627-3341) pg/ml, 2.30±0.19mmol/l, and 1.60±0.24mmol/l, respectively. The initial dose was 0.06ug/kg in 6patients and 0.08ug/kg in other 5 patients. The final average dose was 0.11ug/kg at the end of follow-up, with 6 patients achieving dose adjustment reaching desired level within 8 weeks. One patient dropped out due to skin lesion. The proportion of patients with iPTH reduction by >30% and with iPTH reducing to 150-300pg/ml was 73% and 36.4%, respectively, with one patient experiencing hypercalciumemia. No other adverse events were observed. Conclusion: It seemed feasible to initiate paricalcitol treatment at a medium dose in SHPT hemodilysis patients, with few effect on serum Ca and P levels.

Key words: Paricalcitol, initial dose, secondary hyperparathyroidism, hemodialysis