@article{43a03811d9ad40dabab2237a526132ff,
title = "Cholecalciferol additively reduces serum parathyroid hormone levels in severe secondary hyperparathyroidism treated with calcitriol and cinacalcet among hemodialysis patients",
abstract = "We evaluated the improvement of intact parathyroid hormone (iPTH) levels and bone parameters by supplementing nutritional vitamin D (cholecalciferol) to combined calcimimetic (cinacalcet) and active vitamin D analog (calcitriol) among severe secondary hyperparathyroidism (SHPT) hemodialysis (HD) patients. A randomized, controlled open-label study was undertaken in 60 HD patients with serum iPTH > 1000 pg/mL or persistently high iPTH ≥ 600 pg/mL even after >3 months of calcitriol (3 µg/week). The study group received oral cholecalciferol (5000 IU/ day) and the control group received a placebo. All patients received fixed dose cinacalcet (30 mg/day, orally) and calcitriol. Calcitriol was reduced if iPTH ≤ 300 pg/mL and cinacalcet was withdrawn if serum iPTH was persistently low (iPTH ≤ 300 pg/mL) for 4 weeks after the reduction of calcitriol. A significantly lower iPTH level was noted from the 20th week in the study group compared to the placebo group, and the target iPTH ≤ 300 pg/mL was achieved at the 24th week in the study group. Most patients achieved serum 25-(OH)D3 ≥ 30 ng/mL in the study group. Nearly 40% of study patients gained >10% improvement in femoral neck (FN) bone mineral density (BMD). We conclude that cholecalciferol additively reduced serum iPTH levels, improved 25-(OH)D3 levels and improved FN BMD when used together with cinacalcet/calcitriol in severe SHPT HD patients.",
keywords = "Calcitriol, Cholecalciferol, Cinacalcet, Hemodialysis, Secondary hyperparathyroidism, Calcifediol/blood, Calcitriol/blood, Severity of Illness Index, Femur Neck/drug effects, Humans, Hyperparathyroidism, Secondary/blood, Middle Aged, Cinacalcet/blood, Male, Cholecalciferol/blood, Bone Density/drug effects, Calcimimetic Agents/blood, Renal Dialysis/adverse effects, Female, Aged, Vitamins/blood, Dietary Supplements, Parathyroid Hormone/blood",
author = "Zheng, {Cai Mei} and Wu, {Chia Chao} and Hung, {Chi Feng} and Liao, {Min Tser} and Shyu, {Jia Fwu} and Hsu, {Yung Ho} and Lu, {Chien Lin} and Wang, {Yuan Hung} and Zheng, {Jing Quan} and Chang, {Tian Jong} and Lin, {Yuh Feng} and Lu, {Kuo Cheng}",
note = "Funding Information: We acknowledge the commitment and dedication of the study investigators at Cardinal Tien Hospital, Fu Jen Catholic University and Shuang Ho Hospital, Taipei Medical University. The clinical trial was funded by CTH 105A-215, CTH-106A-2B01, 103TMU-SHH-28, CTH-100-1-2A0 and NC10003 for data collection, analysis, and preparation of the study report and manuscript. Publisher Copyright: {\textcopyright} 2018 by the authors. Licensee MDPI, Basel, Switzerland.",
year = "2018",
month = feb,
day = "10",
doi = "10.3390/nu10020196",
language = "English",
volume = "10",
journal = "Nutrients",
issn = "2072-6643",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "2",
}