Abstract
We used elcatonin® in combination with vitamin D3 and calcium carbonate to treat renal osteodystrophy (ROD), especially secondary hyperparathyroidism, in long-term hemodialysis patients, and evaluated its effects by quantitative analysis using bone scintigrams and bone density measurements by the DEXA method. The subjects were patients with bone pain and an AL-P value≥10 KAU undergoing hemodialysis 3 times/week. The dose of vitamin D3 in each patient was constant, and the dose of calcium carbonate was adjusted to maintain a serum Ca concentration of 9-11mg/dl.
Bone scintigraphy was performed, and 12 patients exhibiting a pattern of secondary hyperparathyroidism by visual classification were selected. Seven patients were treated with intravenous drip infusion of 80 units of elcatonin® at every hemodialysis session for 6 months (ECT group). The other 5 patients were studied as controls. HS-PTH level and plasma free hydroxyproline (OH-Pro) levels were high in both groups and did not change during this study. In the ECT group, the AL-P and tartrate-resistant acid phosphatase (TRACP) levels decreased, and lumbar spine bone density (L2-4 BMD) significantly increased (p<0.05). Visual findings on bone scintigrams and the results of quantitative analysis using the RI count also improved in the ECT group compared with the control group. Thus, in ROD patients with high AL-P and HS-PTH levels and secondary hyperparathyroidism on bone scintigrams combination therapy with vitamin D3 and elcatonin® resulted in a decrease in TRACP levels, an increase in lumbar spine bone density, and improvement in bone scintigraphy findings.
