Abstract
A 37-year-old man with long-term dialysis treatment was presented. He had been treated with hemodialysis two or three times a week and had received aluminium hydroxide (10g/day), 1α-OH-D3 (0.25r/day) and calcitonin (80-120mrc/w) for the therapy of renal osteodystrophy. At about 5 years later of the start of hemodialysis, he complained of severe pain on both patella, tuberositas tibiae and right articulatio cubiti. At that time, his serum calcium concentration was 4.5 mEq/liter, serum phosphate, 5.7mg/dl, alkaline phosphatase, 45 K-A unit (normal; 3-12), and PTH, 0.74ng/ml (normal; less than 0.4). The findings of bone X-ray in tibiae showed advanced osteoporotic changes. At 3 years later of the appearance of these symptoms, Dihydrotachysterol (DHT) was medicated instead of 1α-OH-D3. After the treatment of DHT for 5 weeks, his severe bone pains described above were dramatically ameliorated without any changes in laboratory data. The mechanism of the effect of DHT on his bone pains superior to 1α-OH-D3is not clear.
