title: Achievement of recommended treatment targets for bone and mineral metabolism in haemodialysis patients using paricalcitol: an observational study.
abstract: OBJECTIVE
  Secondary hyperparathyroidism (SHPT) is a common problem among patients with chronic kidney disease (CKD) on haemodialysis. This study was conducted to assess the use, effectiveness and safety of intravenous paricalcitol in haemodialysis patients with various degrees of SHPT.
  
  
  METHODS
  This observational, multicentre, prospective study was conducted in 14 Swedish dialysis centres from May 2007 to June 2008 and included 92 haemodialysis patients with a diagnosis of SHPT associated with CKD. The decision to initiate treatment with intravenous paricalcitol was made by the treating physician. No treatment algorithms were provided.
  
  
  RESULTS
  Mean patient age was 64 years. Of the 92 patients included, 74 had an intact parathyroid hormone (iPTH) level of >300 pg/ml at baseline. Median iPTH was 584 pg/ml in patients with a baseline PTH of >300 pg/ml. During follow-up there was a decrease in iPTH to 323 pg/ml at 6 months (-45%, p < 0.0001). In parallel, there was a small increase in serum calcium, but serum phosphorus and the calcium × phosphorus product remained unchanged.
  
  
  CONCLUSIONS
  This study showed that intravenous paricalcitol substantially and safely decreased iPTH in haemodialysis patients with a baseline iPTH above the Kidney Disease Outcomes Quality Initiative recommended target range (150-300 pg/ml) and had minimal impact on serum minerals.
authors.affiliation: Department of Nephrology, Linköping University/Linköping University Hospital, Linköping, Sweden. anders.fernstrom@lio.se
authors.forename: Anders
authors.initials: A
authors.lastname: Fernström
authors.forename: Jan
authors.initials: J
authors.lastname: Giæver
authors.forename: Barbara
authors.initials: B
authors.lastname: Granroth
authors.forename: Britta
authors.initials: B
authors.lastname: Hylander
authors.forename: Gert
authors.initials: G
authors.lastname: Jensen
authors.forename: Anders
authors.initials: A
authors.lastname: Christensson
authors.forename: Björn
authors.initials: B
authors.lastname: Wikström
authors.forename: Lars
authors.initials: L
authors.lastname: Weiss
authors.forename: Ulf
authors.initials: U
authors.lastname: Wrege
authors.forename: Stefan H
authors.initials: SH
authors.lastname: Jacobson
mesh_terms: D000368:Aged; D054316:Biomarkers, Pharmacological / Q000097:blood / Q000378:metabolism*; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002908:Chronic Disease; D004872:Ergocalciferols / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D007275:Injections, Intravenous; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019370:Observation; D010281:Parathyroid Hormone / Q000378:metabolism; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis; D013548:Sweden
chemical_list: D054316:Biomarkers, Pharmacological; D050071:Bone Density Conservation Agents; D004872:Ergocalciferols; D010281:Parathyroid Hormone; D010758:Phosphorus; C084656:paricalcitol; D002118:Calcium