Treatment of renal osteodystrophy with 1,25-dihydroxycholecalciferol.
Nine patients with renal osteodystrophy were tested for 6.5 to 35 months with 1,25-dihydroxycholecalciferol (1,25-DHCC). A close biochemical follow-up was performed during the first 6 months of treatment, including biweekly determinations of serum calcium, phosphorus, magnesium, alkaline phosphatase and creatinine levels. A bone biopsy, radiologic investigations and determinations of plasma levels of immunoreactive parathyroid hormone (IPTH) and intestinal absorption of calcium 47 were performed before and after the 6 months. Although the five patients with osteitis fibrosa showed a significant improvement, the four with predominantly osteomalacic lesions showed no response to treatment. These four had a normal initial plasma iPTH level, higher serum calcium levels than the other five patients, extreme sensitivity to 1,25-DHCC, with frequent episodes of hypercalcemia, and only a slightly increased serum alkaline phosphatase level, which remained unchanged during treatment. All but one of the patients, irrespective of the histologic abnormality, showed a decrease in the uptake of radionuclide by bone after treatment. The renal function of one patient, a man with long-standing stable renal failure who had not undergone dialysis, deteriorated during treatment.
D002117:Calcitriol; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000188:drug therapy*; D004100:Dihydroxycholecalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*
D004100:Dihydroxycholecalciferols; D006887:Hydroxycholecalciferols; D002117:Calcitriol