Abstract
Twenty-two patients with secondary hyperparathyroidism undergoing chronic hemodialysis were treated with maxacalcitol (DCT) for 9 months. Subjects were subdivided into two groups according to the minimal level of high sensitive parathyroid hormone (HS-PTH) during the administration period as 21ng/mL or less (achievement group) and those whose level did not decrease to 21ng/mL (non-achievement group). N-terminal propeptide of type I procollagen (P1NP) was measured as a bone metabolic marker, and the effects on the bone metabolic marker due to OCT administration were investigated. There were 10 subjects in the achievement group and 12 subjects in the non-achievement group.
HS-PTH in the achievement group markedly decreased over time. 1CTP changed from 47.0±25.6ng/mL at the start of administration to 38.2±15.1ng/mL after 3 months in the achievement group, and from 123.2±100.8ng/mL at the start of administration to 99.3±116.9ng/mL after 3 months in the non-achievement group, but after 6 months it decreased significantly to 46.3±19.8ng/mL. P1NP decreased from 179.4±155.4ng/mL at the start of administration to 109.1±62.3ng/mL after 3 months in the achievement group. In the nonachievement group it decreased from 515.1±461.6ng/mL at the start of administration to 380.3±368.3ng/mL after 3 months, and it decreased to 117.5±71.0ng/mL at 9 months similar to that in the achievement group. Corrected serum calcium level showed the same change between the two groups. However, hypercalcemia more than 11.5mg/dL was found in 6 cases in the achievement group, while 3 subjects in the non-achievement group showed hypercalcemia.
The changes in bone metabolic marker by OCT were indicative of an improvement in bone turnover. Similarly to other bone metabolic markers P1NP was also useful.
