Comparison Of The Efficacy And Side Effects Of Intravenous And Oral Calcitriol Pulse Therapies On Maintenance Hemodialysis Patients With Secondary Hyperparathyroidism

Objective: To discuss the efficacy and safety of calcitriol injection and oral drug pulsetherapies in maintenance hemodialysis(MHD)patients with secondary hyperparathyroidism(SHPT).Methods:1 、 40 hemodialysis patients with secondary hyperparathyroidism in our center,not associated with hypercalcemia and hyperphosphatemia,were randomly assigned into intravenous calcitriol group(A group)and oral calcitriol pulse group(B group),treatment 12 weeks.2、Serum i PTH,alkaline phosphatase(AKP),calcium and phosphorus of two groups were monitored before treatment and the next 4、8、12weeks.the side effects and symptom improvement were also recorded.Results: 1 、 After treatment of 4 weeks,both groups serum i PTH levels were significantly reduced(P<0.05).After 12 weeks,the levels of AKP decreased significantly in both groups(P<0.05).2、After 8 weeks,serum i PTH of intravenous group decreased significantly compare to oral pulse group(P <0.05),the difference was still significant until the end of treatment.3、Change in serum calcium:Serum calcium tended to increase in both groups in the later treatment.B group had significant changes in serum calcium(P<0.05).4、There was no significant difference in serum phosphorus between the two groups before and after treatment.5 、 Clinical symptoms such as osteodynia,restless legs,pruritus and anemia improved to various degrees in both groups,while more significant improvement in pruritus of A group(P<0.05).Conclusion: Oral pulse and intravenous calcitriol therapies can effectively decrease the levels of i PTH and AKP in chronic hemodialysis patients with secondary hyperparathyroidism,and relieve osteodynia and pruritus.Hypercalcemia is the main side effect.Intravenous calcitriol has more rapid and significant effect compared with oral pulse therapy,with less hypercalcemia.better safety and convenient in maintenance hemodialysis patients,better compliance at the end of hemodialysis.