Acute Effect of Pamidronate on PTH Secretion in Postmenopausal Hemodialysis Patients with Secondary Hyperparathyroidism

Kuo Cheng Lu, Lai King Yeung, Shih Hua Lin, Yuh Feng Lin, Pauling Chu

研究成果: 雜誌貢獻文章同行評審

25 引文 斯高帕斯(Scopus)


Background: The purpose of this study is to evaluate the acute effect of pamidronate on plasma ionized calcium (iCa) level reduction and dynamic parathyroid hormone (PTH) secretion in postmenopausal hemodialysis-dependent women with secondary hyperparathyroidism. Methods: Twelve postmenopausal women undergoing regular hemodialysis with serum intact PTH levels greater than 200 pg/mL (200 ng/L) were included in this study. Pamidronate was administered intravenously as a single dose of 15 mg in the last hour of hemodialysis. PTH responses to hypocalcemia and hypercalcemia induced with 1 mEq/L (0.5 mmol/L) and 4 mEq/L (2 mmol/L) of dialysate calcium, respectively, were evaluated before and 1 week after pamidronate therapy. Results: Pamidronate therapy resulted in a decrease in predialysis basal plasma iCa (iCabase; P < 0.05) levels and an increase in maximal serum PTH (PTHmax; P < 0.001), basal PTH (PTHbase; P < 0.001), and minimal PTH levels (P < 0.001). The set point of serum calcium and the slope of the PTH-calcium curve were not altered by pamidronate therapy. An inverse correlation was present between iCabase and the PTHbase-PTHmax ratio before (r = -0.66; P < 0.05) and after (r = -0.84; P < 0.001) pamidronate therapy. Conclusion: Our study shows that pamidronate therapy is associated with reduced plasma iCa levels and increased PTH secretion, resulting in aggravated secondary hyperparathyroidism. These findings suggest that secondary hyperparathyroidism may worsen after the administration of pamidronate, at least in the short term, in postmenopausal hemodialysis patients.

頁(從 - 到)1221-1227
期刊American Journal of Kidney Diseases
出版狀態已發佈 - 12月 2003

ASJC Scopus subject areas

  • 腎臟病學


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