An analysis of the efficacy of pulse administration of alfacalcidol and calcitriol in the treatment of secondary hyperparathyroidism in hemodialysis patients

ObjectiveTo compare the efficacy of pulse administration of alfacalcidol and calcitriol in the treatment of secondary hyperparathyroidism (SHPT) in maintenance hemodialysis patients, and the effects on the levels of serum calcium and phosphorus. MethodsA total of 37 maintenance hemodialysis patients with the serum parathyroid hormone (iPTH) levels of 300-500 ng/L were enrolled. They were randomly divided into an alfacalcidol treatment group and a calcitriol treatment group. The observation time was 12 weeks, which was stopped when the level of iPTH was less than 150-300 ng/L. Then, the levels of serum iPTH, calcium and phosphorus levels were measured before and 4, 8 and 12 weeks after treatment. ResultsCompared with those before treatment, the iPTH levels were remarkable reduced in both the alfacalcidol group (P<0.01) and the calcitriol group (P<0.01) on Week 12 after treatment. But, there was no significant difference in iPTH level between the two groups (P>0.05). After treatment, both groups presented markedly higher levels of serum calcium than those before treatment (P<0.05 or P<0.01), but there was no significant difference in the level of serum calcium between the two groups (P>0.05). Compared with those before treatment, the amount of serum phosphorus was remarkably increased in the calcitriol group 12 weeks after treatment (P<0.05). However, no statistical significance was found as to the amount of serum phosphorus in the alfacalcidol treatment group before and after treatment (P>0.05). ConclusionsPulse administration of alfacalcidol and calcitriol is significantly effective on SHPT in hemodialysis patients. There is no significant difference in the levels of serum calcium and phosphorus between the two groups.