title: Efficacy of intravenous alfacalcidol in the treatment of secondary hyperparathyroidism in patients on hemodialysis.
abstract: BACKGROUND
  Secondary hyperparathyroidism remains a serious problem in hemodialysis patients. The therapy of renal osteodystrophy is mainly based on lowering phosphate levels and administering vitamin D(3) metabolites and calcimimetic agents.
  
  
  METHODS
  An observational, prospective, multicenter study was made to evaluate the efficacy of alfacalcidol in 185 chronic hemodialysis patients with secondary hyperparathyroidism (i-PTH >150 pg/ml). Patients with a CaxP product >70 were excluded. Intermittent therapy with intravenous alfacalcidol was observed for 6 months.
  
  
  RESULTS
  The mean dose of alfacalcidol per week was 3.63 +/- 1.71 microg. Patients previously treated with vitamin D(3) metabolites needed higher doses of alfacalcidol (4.0 +/- 1.7 vs. 3.2 +/- 1.6; p = 0.01). Only 50.8% of the patients had received vitamin D(3) metabolites prior to the start of the study and at baseline they had higher i-PTH levels (600.3 +/- 360.5 vs. 489.9 +/- 292.6, p = 0.02). i-PTH levels decreased from 546 +/- 332.6 to 332.4 +/- 274.5 pg/ml (p < 0.001). 60.5% of the patients had i-PTH < 300 pg/ml at the last observation. Serum calcium increased (9.4 +/- 0.8 to 9.97 +/- 1.0 mg/l, p < 0.001).
  
  
  CONCLUSIONS
  Alfacalcidol reduced the levels of i-PTH and produced a slight increase in serum calcium and phosphate levels. In mild or moderate hyperparathyroidism the doses needed were lower than in severe hyperparathyroidism.
authors.affiliation: Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: M T
authors.initials: MT
authors.lastname: González
authors.forename: J V
authors.initials: JV
authors.lastname: Torregrosa
authors.forename: E
authors.initials: E
authors.lastname: Colomé
authors.forename: A
authors.initials: A
authors.lastname: Mendia
authors.forename: M
authors.initials: M
authors.lastname: Pavesi
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy* / Q000209:etiology; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011446:Prospective Studies; D012016:Reference Values; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D006887:Hydroxycholecalciferols; D010281:Parathyroid Hormone; C008088:alfacalcidol