Abstract
Introduction: Secondary hyperparathyroidism, is a matter of concern in hemodialysis patients that cause renal osteodystrophy eventually.
Objectives: The objective of the study was to compare the efficacy of cholecalciferol with calcitriol for treating secondary hyperparathyroidism.
Materials and Methods: This study is a randomized, controlled study. Around 80 patients with hyperparathyroidism (PTH >300 ρg/mL) and 25(OH)D level <20 ng/mL were divided into two groups to receive cholecalciferol 50 000 IU/3 times in one week or calcitriol 0.25 μg/daily for 12 weeks. Additionally calcium carbonate 1000-1500 mg/d/tablets is prescribed for both groups. Reduction of parathyroid hormone (PTH), changes of plasma albumin-corrected calcium and phosphorus and levels of 25(OH)D were analyzed.
Results: Around 40 patients were randomized into each group. At baseline, plasma albumin-corrected calcium, phosphorus and intact PTH and 25(OH)D had no difference between groups. At week 12, intact PTH levels in cholecalciferol and calcitriol groups were 242.38 ± 16.38 ρg/mL and 237.84 ± 13.65 ρg/mL in respectively. Patients who achieved target intact PTH of <300 ρg/mL were 90% in the cholecalciferol and 95% in the calcitriol group (P = 0.447). Serum calcium and phosphorus were not significantly different in both groups. Serum calcium; 9.07 ± 0.36 mg/dL versus 9.00 ± 0.38 mg/dL (P = 0.607), phosphorus; 4.81 ± 0.55 mg/dL versus 4.15 ± 0.42 mg/dL (P = 0.126) in cholecalciferol and calcitriol groups respectively. Furthermore, serum 25(OH)D levels significantly rise in cholecalciferol group. Serum 25(OH)D levels were 62.98 ±21.03 ng/mL in cholecalciferol group and 18.95 ± 22.70 ng/mL in calcitriol group (P < 0.05).
Conclusion: cholecalciferol can be administered to control secondary hyperparathyroidism and vitamin D(25OH) deficiency in hemodialysis patients. The two drugs are equally efficacious and lead to similar changes in calcium and phosphorus levels.