Follow-up study of patients with long-term maxacalcitol therapy on secondary hyperparathyroidism

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  • 二次性副甲状腺機能亢進症に対するマキサカルシトール長期使用の予後調査
  • 2ジセイ フクコウジョウセン キノウ コウシンショウ ニ タイスル マキサカルシトール チョウキ シヨウ ノ ヨゴ チョウサ

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Abstract

Background : Reports about long-term maxacalcitol (OCT) therapy for secondary hyperparathyroidism (SHPT) are rare. Material and Methods : Seventy hemodialysis (HD) patients with a serum intact parathyroid hormone (iPTH) level>200pg/mL and serum albumin corrected calcium (cCa) level<11.5mg/dL were enrolled. OCT was given three times weekly for 24 weeks. Doses were adjusted according to iPTH and cCa levels on the first day of every other week. After evaluation at 24 weeks, the patients were continued with OCT or intervention therapy for SHPT. The condition of each patient was studied using questionnaires sent to each attending physician about 5 years later. Results : At 24 weeks, 31 patients (44.3%) showed an iPTH level<200pg/mL, and 27 patients (38.6%) showed an iPTH decrease>50%. Eleven patients (15.7%) showed hypercalcemia, which was related to the initial cCa level (p=0.0003). In the follow-up study, 27 patients died, two patients underwent kidney transplantation and two patients were lost to follow-up after changing hospitals. Five HD patients underwent parathyroidectomy. At the end of December 2006, compared with the data at 24 weeks', iPTH had significantly decreased, cCa had significantly increased and serum P had not changed. In the last six months, 21 HD patients were maintained with OCT therapy against 8 HD patients who had stopped it. Between the two groups, iPTH showed a significant difference. Conclusions : These findings suggest that long-term OCT therapy is useful for SHPT in some patients.

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