Cholecalciferol additively reduces serum parathyroid hormone levels in severe secondary hyperparathyroidism treated with calcitriol and cinacalcet among hemodialysis patients

Cai Mei Zheng, Chia Chao Wu, Chi Feng Hung, Min Tser Liao, Jia Fwu Shyu, Yung Ho Hsu, Chien Lin Lu, Yuan Hung Wang, Jing Quan Zheng, Tian Jong Chang, Yuh Feng Lin, Kuo Cheng Lu

研究成果: 雜誌貢獻文章

6 引文 (Scopus)

摘要

We evaluated the improvement of intact parathyroid hormone (iPTH) levels and bone parameters by supplementing nutritional vitamin D (cholecalciferol) to combined calcimimetic (cinacalcet) and active vitamin D analog (calcitriol) among severe secondary hyperparathyroidism (SHPT) hemodialysis (HD) patients. A randomized, controlled open-label study was undertaken in 60 HD patients with serum iPTH > 1000 pg/mL or persistently high iPTH ≥ 600 pg/mL even after >3 months of calcitriol (3 µg/week). The study group received oral cholecalciferol (5000 IU/ day) and the control group received a placebo. All patients received fixed dose cinacalcet (30 mg/day, orally) and calcitriol. Calcitriol was reduced if iPTH ≤ 300 pg/mL and cinacalcet was withdrawn if serum iPTH was persistently low (iPTH ≤ 300 pg/mL) for 4 weeks after the reduction of calcitriol. A significantly lower iPTH level was noted from the 20th week in the study group compared to the placebo group, and the target iPTH ≤ 300 pg/mL was achieved at the 24th week in the study group. Most patients achieved serum 25-(OH)D3 ≥ 30 ng/mL in the study group. Nearly 40% of study patients gained >10% improvement in femoral neck (FN) bone mineral density (BMD). We conclude that cholecalciferol additively reduced serum iPTH levels, improved 25-(OH)D3 levels and improved FN BMD when used together with cinacalcet/calcitriol in severe SHPT HD patients.

原文英語
文章編號196
期刊Nutrients
10
發行號2
DOIs
出版狀態已發佈 - 二月 10 2018

指紋

hyperparathyroidism
calcitriol
Secondary Hyperparathyroidism
hemodialysis
parathyroid hormone
cholecalciferol
Calcitriol
Cholecalciferol
Parathyroid Hormone
Renal Dialysis
Serum
Femur Neck
bone density
thighs
vitamin D
Vitamin D
Bone Density
placebos
Placebos
Cinacalcet Hydrochloride

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

引用此文

Cholecalciferol additively reduces serum parathyroid hormone levels in severe secondary hyperparathyroidism treated with calcitriol and cinacalcet among hemodialysis patients. / Zheng, Cai Mei; Wu, Chia Chao; Hung, Chi Feng; Liao, Min Tser; Shyu, Jia Fwu; Hsu, Yung Ho; Lu, Chien Lin; Wang, Yuan Hung; Zheng, Jing Quan; Chang, Tian Jong; Lin, Yuh Feng; Lu, Kuo Cheng.

於: Nutrients, 卷 10, 編號 2, 196, 10.02.2018.

研究成果: 雜誌貢獻文章

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abstract = "We evaluated the improvement of intact parathyroid hormone (iPTH) levels and bone parameters by supplementing nutritional vitamin D (cholecalciferol) to combined calcimimetic (cinacalcet) and active vitamin D analog (calcitriol) among severe secondary hyperparathyroidism (SHPT) hemodialysis (HD) patients. A randomized, controlled open-label study was undertaken in 60 HD patients with serum iPTH > 1000 pg/mL or persistently high iPTH ≥ 600 pg/mL even after >3 months of calcitriol (3 µg/week). The study group received oral cholecalciferol (5000 IU/ day) and the control group received a placebo. All patients received fixed dose cinacalcet (30 mg/day, orally) and calcitriol. Calcitriol was reduced if iPTH ≤ 300 pg/mL and cinacalcet was withdrawn if serum iPTH was persistently low (iPTH ≤ 300 pg/mL) for 4 weeks after the reduction of calcitriol. A significantly lower iPTH level was noted from the 20th week in the study group compared to the placebo group, and the target iPTH ≤ 300 pg/mL was achieved at the 24th week in the study group. Most patients achieved serum 25-(OH)D3 ≥ 30 ng/mL in the study group. Nearly 40{\%} of study patients gained >10{\%} improvement in femoral neck (FN) bone mineral density (BMD). We conclude that cholecalciferol additively reduced serum iPTH levels, improved 25-(OH)D3 levels and improved FN BMD when used together with cinacalcet/calcitriol in severe SHPT HD patients.",
keywords = "Calcitriol, Cholecalciferol, Cinacalcet, Hemodialysis, Secondary hyperparathyroidism",
author = "Zheng, {Cai Mei} and Wu, {Chia Chao} and Hung, {Chi Feng} and Liao, {Min Tser} and Shyu, {Jia Fwu} and Hsu, {Yung Ho} and Lu, {Chien Lin} and Wang, {Yuan Hung} and Zheng, {Jing Quan} and Chang, {Tian Jong} and Lin, {Yuh Feng} and Lu, {Kuo Cheng}",
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T1 - Cholecalciferol additively reduces serum parathyroid hormone levels in severe secondary hyperparathyroidism treated with calcitriol and cinacalcet among hemodialysis patients

AU - Zheng, Cai Mei

AU - Wu, Chia Chao

AU - Hung, Chi Feng

AU - Liao, Min Tser

AU - Shyu, Jia Fwu

AU - Hsu, Yung Ho

AU - Lu, Chien Lin

AU - Wang, Yuan Hung

AU - Zheng, Jing Quan

AU - Chang, Tian Jong

AU - Lin, Yuh Feng

AU - Lu, Kuo Cheng

PY - 2018/2/10

Y1 - 2018/2/10

N2 - We evaluated the improvement of intact parathyroid hormone (iPTH) levels and bone parameters by supplementing nutritional vitamin D (cholecalciferol) to combined calcimimetic (cinacalcet) and active vitamin D analog (calcitriol) among severe secondary hyperparathyroidism (SHPT) hemodialysis (HD) patients. A randomized, controlled open-label study was undertaken in 60 HD patients with serum iPTH > 1000 pg/mL or persistently high iPTH ≥ 600 pg/mL even after >3 months of calcitriol (3 µg/week). The study group received oral cholecalciferol (5000 IU/ day) and the control group received a placebo. All patients received fixed dose cinacalcet (30 mg/day, orally) and calcitriol. Calcitriol was reduced if iPTH ≤ 300 pg/mL and cinacalcet was withdrawn if serum iPTH was persistently low (iPTH ≤ 300 pg/mL) for 4 weeks after the reduction of calcitriol. A significantly lower iPTH level was noted from the 20th week in the study group compared to the placebo group, and the target iPTH ≤ 300 pg/mL was achieved at the 24th week in the study group. Most patients achieved serum 25-(OH)D3 ≥ 30 ng/mL in the study group. Nearly 40% of study patients gained >10% improvement in femoral neck (FN) bone mineral density (BMD). We conclude that cholecalciferol additively reduced serum iPTH levels, improved 25-(OH)D3 levels and improved FN BMD when used together with cinacalcet/calcitriol in severe SHPT HD patients.

AB - We evaluated the improvement of intact parathyroid hormone (iPTH) levels and bone parameters by supplementing nutritional vitamin D (cholecalciferol) to combined calcimimetic (cinacalcet) and active vitamin D analog (calcitriol) among severe secondary hyperparathyroidism (SHPT) hemodialysis (HD) patients. A randomized, controlled open-label study was undertaken in 60 HD patients with serum iPTH > 1000 pg/mL or persistently high iPTH ≥ 600 pg/mL even after >3 months of calcitriol (3 µg/week). The study group received oral cholecalciferol (5000 IU/ day) and the control group received a placebo. All patients received fixed dose cinacalcet (30 mg/day, orally) and calcitriol. Calcitriol was reduced if iPTH ≤ 300 pg/mL and cinacalcet was withdrawn if serum iPTH was persistently low (iPTH ≤ 300 pg/mL) for 4 weeks after the reduction of calcitriol. A significantly lower iPTH level was noted from the 20th week in the study group compared to the placebo group, and the target iPTH ≤ 300 pg/mL was achieved at the 24th week in the study group. Most patients achieved serum 25-(OH)D3 ≥ 30 ng/mL in the study group. Nearly 40% of study patients gained >10% improvement in femoral neck (FN) bone mineral density (BMD). We conclude that cholecalciferol additively reduced serum iPTH levels, improved 25-(OH)D3 levels and improved FN BMD when used together with cinacalcet/calcitriol in severe SHPT HD patients.

KW - Calcitriol

KW - Cholecalciferol

KW - Cinacalcet

KW - Hemodialysis

KW - Secondary hyperparathyroidism

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