Hypoparathyroidism—a long‐term follow‐up experience with 1α‐vitamin D₃ therapy

Abstract

OBJECTIVE Previous studies have suggested that aipha-DI therapy can cause deterloration In renal functlon. We have, therefore, examlned the long-term effect of l ahydroxyvitamin D, (alpha-D,) administration upon renal function In hypoparathyroid patients. DESIGN This Is a prospective long-term foliow-up study of alpha-D, admlnlstratlon on hypoparathyroid patients at a mean dally dose of 1 pg (range 05-25 pg) durlng a total of 2040 patient-months. PATIENTS Seventeen unselected patients (14 females and 3 males), two wlth primary and 15 wlth post-surgical hypoparathyroidism. RESULTS The rlgnlflcant effect of alpha-D, on serum and urinary calcium was achieved during the first week of treatment and remained stable at the same range during the close follow-up of 2040 patlent-months. No slgniflcant Change was observed In the serum creatlnlne durlng the whole follow-up perlod. Durlng follow-up, five women developed hypercalcluria and one patient developed hypercaicaemla that disappeared when the dose of the drug was reduced or dllcontlnued. CONCLUSIONS From our study we concluded that alpha-DI Is a safe and effective drug in the long-term therapy of hypoparathyroid patients.Hypocalcaemia, hyperphosphataemia and reduced serum immunoreactive parathyroid hormone (imH) and 1.25dihydroxyvitamin D (I,25(OH)zD) concentrations are the main biochemical features of hypoparathyroidism (Balsam ef al.. 1975; Rosen ef d., 1977;Breslau & Pak, 1979).Parathyroid hormone stimulates the conversion of 25hydroxyvitamin D to 1.

Pseudohypoparathyroidism as a rare cause of bilateral slipped capital femoral epiphysis

“…Similar to calcitriol, alfacalcidol has a rapid onset of action and a relatively short half-life 16–18. Calcium supplementation is also recommended to increase the serum calcium levels.…”

Treatment of Hypoparathyroidism with Calcium and Vitamin D

“…Its onset is within 1-2 days and it has a longer half-life than calcitriol with an offset of action seen within 5-7 days. 20 Treatment with alfacalcidiol has been associated with decreases in GFR. [21][22][23][24][25] These decreases are believed to be associated with the development of nephrocalcinosis.…”

“…Renal function remained stable. 20 Long-term administration of calcitriol was evaluated in three patients with hypoparathyroidism, six patients with chronic kidney disease, and 10 patients with renal hypophosphatemic rickets. 27 Calcitriol increased serum calcium as well as urinary calcium excretion.…”

“…29,30 Long-term therapy with alfacalcidiol has been evaluated in 17 patients with hypoparathyroidism and prospectively followed over 10 years. 20 Alfacalcidiol was initially given in doses of 2.0 mcg/day in addition to 0.5-1 g/day of calcium glubionate with subsequent dose adjustments based on clinical and laboratory data. Alfacalcidiol increased serum calcium concentrations, but also led to significant increases in urinary calcium excretion.…”

Hypoparathyroidism

“…Метаболиты витамина D и их аналоги необходимы для коррекции проявлений гипо паратиреоза [7,14]. Основным осложнени ем, которого следует избегать, является ин токсикация витамином D (гиперкальциемия и гиперкальциурия) с его побочным воздей ствием на почки и центральную нервную сис тему.…”