Document Detail

Calcitriol pulse therapy in patients with end-stage renal failure.
MedLine Citation:
PMID:  7881985     Owner:  NLM     Status:  MEDLINE    
To maximize the effects of calcitriol on parathyroid glands and bone without inducing frequent episodes of hypercalcemia, two new therapeutic approaches, intravenous therapy and intermittent pulse oral administration, have been advocated. To date, detailed results of 23 studies have been reported. All clinical trials were prospective; however, none included a placebo-control group, and only one study reported on bone histology. Review of these data indicates that in principle, both intravenous and pulse oral therapy are equally efficient in decreasing serum parathyroid hormone levels. However, both approaches induce relatively frequent episodes of hypercalcemia and, to a lesser degree, hyperphosphatemia, necessitating close monitoring during therapy. In addition, a subset of patients did not respond to either therapy without clearcut characteristics that would allow them to be identified before the start of therapy. More controlled studies that include bone histology are needed to elucidate this question. At this time, it appears that patients with severe predominant hyperparathyroidism can benefit from intravenous or pulse oral therapy, which may allow them to avoid parathyroidectomy. However, further studies are needed in patients with mild to moderate secondary hyperparathyroidism to determine whether intermittent therapies are superior to daily oral therapy in preventing parathyroid gland hyperplasia and renal bone disease.
M C Monier-Faugere; H H Malluche
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  3     ISSN:  1062-4821     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1995-04-13     Completed Date:  1995-04-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  615-9     Citation Subset:  IM    
University of Kentucky, Lexington.
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MeSH Terms
Administration, Oral
Bone Diseases / etiology,  prevention & control
Calcitriol / administration & dosage*,  adverse effects
Clinical Trials as Topic
Drug Administration Schedule
Hypercalcemia / chemically induced
Hyperparathyroidism, Secondary / drug therapy,  etiology
Infusions, Intravenous
Kidney Failure, Chronic / complications,  drug therapy*
Prospective Studies
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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