33 51

Cited 0 times in

지속성 외래 복막투석 환자에서 투여 경로에 다른 칼시트리올 효과의 전향적인 비교 연구

Other Titles
 A Prospective Study of the Effect of Calcitriol Treatment according to Administration Route in CAPD Patients 
 이인희  ;  강신욱  ;  노현진  ;  신석균  ;  김은경  ;  최규헌  ;  하성규  ;  유형식  ;  이호영  ;  한대석 
 Korean Journal of Nephrology (대한신장학회지), Vol.18(1) : 148-158, 1999 
Journal Title
 Korean Journal of Nephrology (대한신장학회지) 
Issue Date
To determine the optimal administration route of calcitriol in CAPD patients with secondary hyperparathyroidism, we conducted a prospective study on 33 patients who performed CAPD for more than 6 months an d whose intact parathyroid hormone(iPTH) level was higher than 250pg/mL. The patients were randomized into 3 groups:IP(n=11); 1.0μg of calcitriol once daily via intraperitoneal route by overnight retention with dialysate, SC(n=11); 1.0μg of calcitriol three times a week via subcutaneous route, and PO (n=11); 1.0μg of calcitriol three times a week by ingestion. 11 out of 33 patients(6 in IP, 4 in SC, and 1 in PO) dropped out during the 6-months study period, and 5 among the 6 patients in IP were due to recurrent peritonitis. Biochemical data including calcium, phosphorus, iPTH, alkaline phosphatase, bone-specific alkaline phosphatase, osteocalcin and 1,25(OH)2D3 were measured regularly, and the data of 22 patients who had completed the 6-months study were analyzed. There was a statistically significant decrease in iPTH level(pg/mL) in the three groups after 6-months calcitriol therapy(IP; 812.0±276.7 vs. 354.7±129.4, PO; 571.8±330.7 vs. 159.6±192.3, SC; 786.1±535.0 vs. 551.8±729.9, respectively, P<0.05), but there were no differences in the percentage of decrease in iPTH from baseline values among the three groups. Alkaline phosphatase, bone- specific alkaline phosphatase and osteocalcin also decreased significantly in all three groups(IP; 50.1±14.6, 33.5±11.6, 52.3±10.9% of baseline value; SC; 80.9±14.8, 67.4±20.80, 54.4±11.1% of baseline value; PO; 48.8±24.4, 36.6±23.5, 54.2±11.6% of baseline value, respectively, P<0.05), but they were not different with each other. Among 22 patients who completed the 6-months study, hypercalcemia(Ca≥10.5 mg/dL) occurred in 7 patients(31.8%). IP(2/5, 40%) and SC groups(5/7, 71.4%) had significantly higher incidence of hypercalcemia than PO group(0/10, 0%) (P<0.05). IP group(2/5, 40%) also experienced significantly higher incidence of hyperphosphatemia than SC(1/7, 14.3%) and PO groups(1/10, 10%). Peritonitis occurred significantly more in IP than in SC and PO groups(P<0.05). In conclusion, calcitriol treatment resulted in a significant decrement in iPTH levels in CAPD patients and no significant differences were noted in the iPTH-suppressive effect of calcitriol according to the administration route. Because of higher incidence of peritonitis and hypercalcemia in IP and SQ groups, oral ingestion may be the most optimal route for calcitriol treatment in CAPD patients with secondary hyperparathyroidism.
Files in This Item:
T199901350.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.