Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Jan 2004)
Treatment results with oral Rocaltrol pulse among patients with secondary hyperparathyroidism in hemodialysis ward
Abstract
Background and Objective: Renal osteodystrophy is one of the most important complications of ESRD (End Stage Renal Disease). Prescription of calcium, low phosphate diet and rocaltrol are essential in these patients. The aim of this study was to determine the prevalence of renal osteodystrophy and secondary hyperparathyroidism in ESRD patients were covered by Semnan- Fatemieh hemodialysis center and detect the oral rocaltrol pulse response on secondary hyperparathyroidism and renal osteodystrophy in some of these patients. Methods: In first step, 31 patients with ESRD checked for serum calcium (Ca2+) phosphorous (P), alkaline phosphatase and iPTH (IRMA) and bone deformity in bone x-ray from 2000-2001. In second step, 12 patients were categorized in three groups according to iPTH level and treated with 1, 2, 4 microgram oral-rocaltrol pulse, three times a week for 6 months, respectively. Then Ca2+, P, alkaline phosphatase, iPTH levels and bone graphy compared with before treatment results. Findings: From 31 patients with age average 52±17.7 and hemodialysis duration average 36±22.3 months, 3.5 Percent had Ca2+ level equal or higher than 10.4 mg/dl, 77.3 percent had P level equal or higher than 4.5 mg/dl, 80.6 percent had iPTH level higher than 120 pg/ml and 72.4 percent had alkaline phosphatase level higher than 175 Iu/l. No meaningful correlation observed between hemodialysis duration with serum Ca2+, P and alkaline phosphatase level. In 12 patients treated with oral rocaltrol pulse, meaningful differences observed only between serum iPTH level before and after treatment (P<0.003). Conclusion: In most studied patients, serum P and iPTH level was extremely high that suggest poor control of P and hyperparathyroidism. Oral rocaltrol pulse prescription for 6 months decreased iPTH level but had no effect on Ca2+, P and alkaline phosphatase.
