Back to Search
Start Over
Cholecalciferol Additively Reduces Serum Parathyroid Hormone Levels in Severe Secondary Hyperparathyroidism Treated with Calcitriol and Cinacalcet among Hemodialysis Patients
- Source :
- Nutrients, Nutrients; Volume 10; Issue 2; Pages: 196
- Publication Year :
- 2018
- Publisher :
- MDPI AG, 2018.
-
Abstract
- We evaluated the improvement of intact parathyroid hormone (iPTH) levels and bone parameters by supplementing nutritional vitamin D (cholecalciferol) to combined calcimimetic (cinacalcet) and active vitamin D analog (calcitriol) among severe secondary hyperparathyroidism (SHPT) hemodialysis (HD) patients. A randomized, controlled open-label study was undertaken in 60 HD patients with serum iPTH > 1000 pg/mL or persistently high iPTH ≥ 600 pg/mL even after >3 months of calcitriol (3 μg/week). The study group received oral cholecalciferol (5000 IU/ day) and the control group received a placebo. All patients received fixed dose cinacalcet (30 mg/day, orally) and calcitriol. Calcitriol was reduced if iPTH ≤ 300 pg/mL and cinacalcet was withdrawn if serum iPTH was persistently low (iPTH ≤ 300 pg/mL) for 4 weeks after the reduction of calcitriol. A significantly lower iPTH level was noted from the 20th week in the study group compared to the placebo group, and the target iPTH ≤ 300 pg/mL was achieved at the 24th week in the study group. Most patients achieved serum 25-(OH)D3 ≥ 30 ng/mL in the study group. Nearly 40% of study patients gained >10% improvement in femoral neck (FN) bone mineral density (BMD). We conclude that cholecalciferol additively reduced serum iPTH levels, improved 25-(OH)D3 levels and improved FN BMD when used together with cinacalcet/calcitriol in severe SHPT HD patients.
- Subjects :
- calcitriol
Male
0301 basic medicine
Cinacalcet
endocrine system diseases
Calcimimetic
030232 urology & nephrology
Severity of Illness Index
chemistry.chemical_compound
0302 clinical medicine
secondary hyperparathyroidism
Bone Density
polycyclic compounds
hemodialysis
Nutrition and Dietetics
Femur Neck
Vitamins
Middle Aged
cholecalciferol
cinacalcet
Parathyroid Hormone
Female
lipids (amino acids, peptides, and proteins)
Secondary hyperparathyroidism
medicine.drug
musculoskeletal diseases
medicine.medical_specialty
Calcitriol
Urology
Calcimimetic Agents
Article
03 medical and health sciences
Renal Dialysis
medicine
Humans
Aged
Calcifediol
Hyperparathyroidism
business.industry
medicine.disease
030104 developmental biology
chemistry
Cinacalcet Hydrochloride
Dietary Supplements
Hyperparathyroidism, Secondary
business
Cholecalciferol
Food Science
Subjects
Details
- ISSN :
- 20726643
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Nutrients
- Accession number :
- edsair.doi.dedup.....9063dcae98959a36bd86fa26bd0cd2d6
- Full Text :
- https://doi.org/10.3390/nu10020196