engleski

Effect of calcitriol and paricalcitol on serum parathyroid hormone levels and mineral metabolism disorder in patients on maintenance hemodialysis

Introduction and aim. Mineral-bone disorder in patients on the maintenance hemodialysis (HD) manifests with numerous biochemical changes, especially those in parathyroid hormone (PTH), calcium (Ca), and phosphorus (P) serum levels. The aim of this study was to compare the efficacy of calcitriol and paricalcitol on the reduction of serum PTH levels, and incidence of hypercalcaemia and hyperphosphatemia in this patients group. Methods. We included HD patients in Department of Nephrology, Dialysis and Kidney Transplantation, Clinical Hospital Centre Rijeka, that started treatment with calcitriol or paricalcitol in the period from January 1, 2014, to December 31, 2014. Patients were divided into 2 groups: those treated with calcitriol (Rocaltrol® 0, 25 µg capsules, F.Hoffmann – La Roche Ltd, Basel, Switzerland), and those treated with paricalcitol (Zemplar® 1 µg capsules, Abbvie, Queenborough, Great Britain). We examined serum levels of PTH, Ca and P at the baseline, and after 6 months. Hypercalcemia was defined as serum Ca>2.37 mmol/L. Hyperphosphatemia was defined as serum P>1.78 mmol/L. Results. Out of total 63 patients included, we analyzed 55 of them (age 67.3, 53% male), of whom 26 (47%) patients were treated with calcitriol. At the baseline, there was no statistically significant difference in demographic and laboratory parameters between groups. There was no significant difference in PTH serum levels in the group treated with calcitriol (57.66±54.33 vs. 53.5±32.88 ; P=0.405), and the group treated with paricalcitol (41.76±25, 27 vs. 34.44±23.55 ; P=0.127), after 6 months. There was a significantly higher percentage of patients with hypercalcemia in the group treated with calcitriol, after 6 months (0% vs. 23% ; P=0.030). The percentage of patients with hyperphosphatemia changed, but not significantly, in both groups after 6 months: paricalcitol group (0% vs. 10% ; P=0.309), and calcitriol group (11% vs. 21% ; P=0.496). Conclusions. Calcitriol and paricalcitol are equally efficient in reduction of serum PTH levels in the patients on the maintenance HD, after 6 months. In the group of patients treated with calcitriol, the incidence of hypercalcemia was significantly higher, after 6 months.

calcitriol, paricacitol, parathyroid hormone, hemodialysis

nije evidentirano