Efficacy of different concentration of iPTH on the oral administration α-D₃ therapy in uremic patients

Objective: To observe the efficacy of different concentration of iPTH on oral pulse α-D₃therapy in uremia patients.Methods: Forty maintance hemodialysis patients were randomly divided into two groups.According to iPTH level（（pg/ml））,each group was divided into two subgroups,A1 and B1group（200＜iPTH＜500pg/ml）,A2 and B2 group（iPTH≥500pg/ml） to receive α-D₃either pulse（A1 group 2μg twice or A2 group 2μg thrice weekly）or daily（0.25 μg every day）oral alfacalcidol in a 8weeks course.The therapeutic end-point was iPTH＜200pg/ml.The changes of iPTH,SCa,SP,AKP and the functions of liver and kidney were observed before and after treatment of the 4th、 8th weeks.Results: In A1 group,iPTH decreased significantly（201.32±129.87） vs（332.12±131.29l）,P＜0.05After 4 weeks treatment and more significantly after 8 weeks（152.78±101.21） vs（332.12±131.29）,P＜0.01;In A2 group,iPTH decreased significantly（489.45±（119.68）） vs（713.34±137.19）,P＜0.05 after 8 weeks treatment.Mean decrease iPTH in A1 group（60.24±7.93）% was significantly higher then that in A2 group（31.37±8.63）%.The percentage of patients reaching end-point in A1 group was significantly higher than other groups（P＜0.01）.AKP levels decreased significantly in both A1 and A2 after treatment.Conclusion: The efficacy of oral pulse therapy was superior to those of maintance hemodialysis in moderate secondary hyperparathyroidism patients.