Abstract
A biologically active metabolite of vitamin D3, 1α-hydroxyvitamin D3 (1α-OH-D3), has been administered to patients on regular hemodialysis treatment. A total of 217 patients were divided into 5 groups according to the duration of hemodialysis therapy, and the effects of 1α-OH-D3 on abnormal calcium metabolism were evaluated in each group, mainly in terms of the following items:
1) Incidence of patients who showed radiological subperiosteal resorption in the fingers.
The incidence decreased gradually as the number of patients receiving 1α-OH-D3 increased.
2) Percent of patients with hypocalcemia (serum calcium level less than 4.0mEq/l).
Although the number of patients with hypocalcemia definitely decreased, the number whose serum calcium was more than 4.5mEq/l did not increase significantly.
3) Percent of patients showing abnormally high serum c-PTH levels (more than 10.0ng/ml). In the patients who received vitamin D3 within one year of the start of dialysis therapy, the c-PTH levels were supressed in the short term (within 3 years), but in the long term, the percent of patients showing abnormally high serum c-PTH levels increased gradually.
It is concluded from these results that giving vitamin D3 to hemodialysis patients should be started early in the course of dialysis therapy, and that serum calcium levels of the patients receiving 1α-OH-D3 should be maintained as near normal as possible.
