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AuthorSawalmeh, Osama
AuthorMoala, Shaheed
AuthorHamdan, Zakaria
AuthorMasri, Huda
AuthorAyoub, Khubaib
AuthorKhazneh, Emad
AuthorShraim, Mujahed
Available date2018-02-08T10:44:42Z
Publication Date2018-01-15
Publication NameInternational Journal of Nephrology and Renovascular Diseaseen_US
Identifierhttp://dx.doi.org/10.2147/IJNRD.S149877
CitationSawalmeh. el at. (2018) Pulse versus daily oral Alfacalcidol treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized controlled trial. International Journal of Nephrology and Renovascular Disease. Volume 2018:11 , pp 25-32
URIhttp://hdl.handle.net/10576/6285
AbstractSecondary hyperparathyroidism is a common complication of chronic kidney disease and is managed using vitamin D replacement therapy. Very few studies have examined the effectiveness of pulse alfacalcidol therapy in comparison to daily oral alfacalcidol therapy in suppressing serum parathyroid hormone (PTH) levels in hemodialysis patients. The aim of this randomized controlled trial was to replicate the findings of prior studies comparing effectiveness of pulse oral alfacalcidol therapy versus daily oral alfacalcidol therapy in suppressing PTH after 13 weeks of therapy using a Palestinian sample of hemodialysis patients, and to identify demographic and biomedical characteristics of patients that are independently associated with PTH levels. One hundred and sixty-seven patients completed the study, 88 in the daily group and 79 in the pulse group. The pulse group had more clinically significant reduction in mean PTH level by 75 pg/dL at 13 weeks than the daily group, but this was not statistically significant. The effect of alfacalcidol therapy on metabolism of phosphate and corrected calcium levels was comparable in both groups, and pulse therapy was not associated with increased risk of hypercalcemia and hyperphosphatemia. Serum PTH levels were independently and inversely associated with older age and diabetes. Switching daily alfacalcidol therapy to thrice-weekly alfacalcidol pulse therapy seems safe and convenient, especially for hemodialysis patients with poor compliance with treatment. This study also highlights the importance of monitoring and preventing malnutrition in hemodialysis patients and maintaining optimal glycemic control in diabetic hemodialysis patients.
Languageen
PublisherDove Medical Press
Subjectalfacalcidol
Subjectend-stage kidney disease
Subjecthemodialysis
Subjecthyperparathyroidism
Subjectparathyroid hormone
Subjectpulse therapy
Subjectrandomized controlled trials
TitlePulse versus daily oral Alfacalcidol treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized controlled trial.
TypeArticle
Pagination25-32
Volume Number2018:11
ESSN1178-7058


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