Document Detail

No difference between alfacalcidol and paricalcitol in the treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized crossover trial.
MedLine Citation:
PMID:  21832979     Owner:  NLM     Status:  MEDLINE    
Alfacalcidol and paricalcitol are vitamin D analogs used for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease, but have known dose-dependent side effects that cause hypercalcemia and hyperphosphatemia. In this investigator-initiated multicenter randomized clinical trial, we originally intended two crossover study periods with a washout interval in 86 chronic hemodialysis patients. These patients received increasing intravenous doses of either alfacalcidol or paricalcitol for 16 weeks, until parathyroid hormone was adequately suppressed or calcium or phosphate levels reached an upper threshold. Unfortunately, due to a period effect, only the initial 16-week intervention period for 80 patients was statistically analyzed. The proportion of patients achieving a 30% decrease in parathyroid hormone levels over the last four weeks of study was statistically indistinguishable between the two groups. Paricalcitol was more efficient at correcting low than high baseline parathyroid hormone levels, whereas alfacalcidol was equally effective at all levels. There were no differences in the incidence of hypercalcemia and hyperphosphatemia. Thus, alfacalcidol and paricalcitol were equally effective in the suppression of secondary hyperparathyroidism in hemodialysis patients while calcium and phosphorus were kept in the desired range.
Ditte Hansen; Knud Rasmussen; Henning Danielsen; Helmut Meyer-Hofmann; Egidijus Bacevicius; Thomas G Lauridsen; Jens K Madsen; Birgitte G Tougaard; Peter Marckmann; Peter Thye-Roenn; Jørgen E Nielsen; Svend Kreiner; Lisbet Brandi
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-08-10
Journal Detail:
Title:  Kidney international     Volume:  80     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-30     Completed Date:  2012-02-02     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  841-50     Citation Subset:  IM    
Section of Nephrology, Department of Medicine, Roskilde Hospital, Roskilde, Denmark.
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MeSH Terms
Calcium / blood
Cross-Over Studies
Ergocalciferols / adverse effects,  therapeutic use*
Hydroxycholecalciferols / adverse effects,  therapeutic use*
Hyperparathyroidism, Secondary / drug therapy*
Middle Aged
Parathyroid Hormone / blood
Phosphorus / blood
Renal Dialysis / adverse effects*
Reg. No./Substance:
0/Ergocalciferols; 0/Hydroxycholecalciferols; 0/Parathyroid Hormone; 131918-61-1/paricalcitol; 7440-70-2/Calcium; 7723-14-0/Phosphorus; URQ2517572/alfacalcidol
Comment In:
Kidney Int. 2011 Oct;80(8):793-6   [PMID:  21832981 ]

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

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