title: Effectiveness of treatment with oral paricalcitol in patients with pre-dialysis chronic kidney disease.
abstract: OBJECTIVE
  Secondary hyperparathyroidism is a common complication in patients with chronic kidney disease. Treatment with paricalcitol, a selective vitamin D receptor (VDR) activator, has shown benefits in these patients by adequately reducing PTH levels with minimal changes in serum calcium and phosphorus. The aim of this study was to assess the effectiveness and safety of paricalcitol in chronic renal disease patients (CKD grades 3 and 4).
  
  
  METHODS
  A study of our experience with paricalcitol was conducted in normal clinical practice in patients over 18 years diagnosed with grade 3 or 4 chronic kidney disease. Patients were periodically evaluated every 3 months. The primary endpoint of effectiveness was to obtain two consecutive decreases of ≥30% in iPTH with respect to baseline values. The secondary endpoints were fulfilment of the objectives in accordance with the Spanish Society of Nephrology (SEN) and Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines, as well as the relationship between the effectiveness of the treatment and different patient variables. Safety was studied by means of hypercalcaemia events.
  
  
  RESULTS
  The primary study endpoint was achieved in 54.3% of patients. In addition, another 16.3% of patients had reduced iPTH by more than 30% at the 3rd visit. Therefore, 70.6% of patients reduced their iPTH levels by more than 30% in 6 months. The relationship between treatment success and both glomerular filtration rate and body mass index was significant. There were few adverse events, although hypercalcaemia was found in 5.4% of patients.
  
  
  CONCLUSIONS
  Treatment with paricalcitol is effective in controlling secondary hyperparathyroidism in non-dialysed patients with a wide safety margin.
authors: Department of Nephrology, San Cecilio University Hospital, Miguel Ruiz del Castillo 4, Granada, Spain.jhervas@ugr.es
authors: José Gregorio
authors: JG
authors: Hervás Sánchez
authors: María Dolores
authors: MD
authors: Prados Garrido
authors: Aurora
authors: A
authors: Polo Moyano
authors: Sebastian
authors: S
authors: Cerezo Morales
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002118:Calcium / Q000097:blood; D002908:Chronic Disease; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications; D004305:Dose-Response Relationship, Drug; D004341:Drug Evaluation; D023381:Endpoint Determination; D004872:Ergocalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000517:prevention & control; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D004872:Ergocalciferols; D010281:Parathyroid Hormone; D010758:Phosphorus; C084656:paricalcitol; D002118:Calcium