Oral 1, 25(OH)₂ D₃ pulse therapy for the treatment of secondary hyperparathyroidism

Abstract

We examined the effect of oral 1, 25(OH)₂D₃ pulse therapy in hemodialyzed patients with secondary hyperparthyroidism (2°HPT). Prescription of 6.0μg 1, 25(OH)₂D₃once a week combined with calcium carbonate as a phosphate binder during the last 5 days a week for 12 weeks resulted in improvement of mild to moderate 2°HPT despite no significant differences in serum total calcium and phosphate concentration. In addition, the effect was greater in cases with mild 2°HPT. A single administration of 6μg 1, 25(OH)₂D₃ reduced the parathyroid hormone concentration in patients with mild 2°HPT or with a short duration of hemodialysis. Tmax of the serum 1, 25(OH)₂D₃ after single administration of 6.0μg 1, 25(OH)₂D₃ was individually different (range, 0.4-20.9 hrs). It is recommended that early employment of oral 1, 25(OH)₂D₃ pulse therapy be undertaken once a week combined with prescription of calcium salt as a phosphate binder during the last 5 days a week for the treatment of 2°HPT refractory to conventional therapy, since there is no risk of aluminum accumulation with satisfactory control of the serum total calcium and phosphate concentration.