Persistence of dialysis osteomalacia despite treatment with 24R,25-dihydroxycholecalciferol.
Five patients with symptomatic osteomalacia undergoing chronic hemodialysis took 24R,25-dihydroxycholecalciferol, 10 micrograms/day, for periods of 6-20 months. Four patients took calcitriol simultaneously in doses consistent with normocalcemia, but the 5th was unable to do so because of recurrent hypercalcemia. In the group as a whole, despite achievement of physiologic plasma concentrations of 24,25-dihydroxyvitamin D, we could demonstrate no metabolic or histologic benefit of therapy. Substantial osteomalacia persisted in all posttreatment biopsy specimens, appearing more severe in some cases and less severe in others. At the doses prescribed, the results of treatment of dialysis osteomalacia with 24R,25-dihydroxycholecalciferol were clinically unsatisfactory.
Phelps
K R
KR
Department of Medicine, State University of New York Health Science Center, Brooklyn.
Einhorn
T A
TA
Vigorita
V J
VJ
Jones
G
G
Lundin
A P
AP
D015650:24,25-Dihydroxyvitamin D 3; D001706:Biopsy; D001842:Bone and Bones / Q000473:pathology; D004100:Dihydroxycholecalciferols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D010018:Osteomalacia / Q000188:drug therapy* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors
D004100:Dihydroxycholecalciferols; D015650:24,25-Dihydroxyvitamin D 3