Next Article in Journal
Compliance with Dietary Guidelines Varies by Weight Status: A Cross-Sectional Study of Australian Adults
Previous Article in Journal
Effectiveness and Safety of a Probiotic-Mixture for the Treatment of Infantile Colic: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial with Fecal Real-Time PCR and NMR-Based Metabolomics Analysis
Article Menu
Issue 2 (February) cover image

Export Article

Open AccessArticle
Nutrients 2018, 10(2), 196; https://doi.org/10.3390/nu10020196

Cholecalciferol Additively Reduces Serum Parathyroid Hormone Levels in Severe Secondary Hyperparathyroidism Treated with Calcitriol and Cinacalcet among Hemodialysis Patients

1
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
2
Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
3
Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
4
Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
5
School of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan
6
Graduate Institute of Biomedical and Pharmaceutical Science, Fu-Jen Catholic University, New Taipei City 242, Taiwan
7
Department of Pediatrics, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan
8
Division of Pediatrics, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
9
Department of Biology and Anatomy, National Defense Medical Center, Taipei 114, Taiwan
10
Division of Nephrology, Department of Medicine, Cardinal-Tien Hospital & Fu-Jen Catholic University Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan
11
Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
12
Division of Critical Care, Department of Critical Care Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
13
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan
14
Performance Appraisal Section, Secretary Office, Shuang Ho Hospital, Taipei Medical University, Taipei 235, Taiwan
*
Authors to whom correspondence should be addressed.
Received: 18 January 2018 / Revised: 7 February 2018 / Accepted: 8 February 2018 / Published: 10 February 2018
Full-Text   |   PDF [637 KB, uploaded 10 February 2018]   |  

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. View Full-Text
Keywords: cholecalciferol; hemodialysis; secondary hyperparathyroidism; cinacalcet; calcitriol cholecalciferol; hemodialysis; secondary hyperparathyroidism; cinacalcet; calcitriol
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Zheng, C.-M.; Wu, C.-C.; Hung, C.-F.; Liao, M.-T.; Shyu, J.-F.; Hsu, Y.-H.; Lu, C.-L.; Wang, Y.-H.; Zheng, J.-Q.; Chang, T.-J.; Lin, Y.-F.; Lu, K.-C. Cholecalciferol Additively Reduces Serum Parathyroid Hormone Levels in Severe Secondary Hyperparathyroidism Treated with Calcitriol and Cinacalcet among Hemodialysis Patients. Nutrients 2018, 10, 196.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top