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Paricalcitol versus calcitriol treatment for hyperparathyroidism in pediatric hemodialysis patients

Wacharee Seeherunvong1, Obioma Nwobi, Carolyn L Abitbol

  • 1Division of Pediatric Nephrology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Pediatric Nephrology (Berlin, Germany)
|August 11, 2006
PubMed

Insights

Paricalcitol and calcitriol show similar efficacy in treating secondary hyperparathyroidism in pediatric dialysis patients. Paricalcitol may reduce elevated calcium x phosphorus product, suggesting its safety and effectiveness.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Secondary hyperparathyroidism (SHPT) presents a treatment challenge in pediatric dialysis.
  • Paricalcitol, a vitamin D analogue, has shown promise in adults with SHPT.

Purpose of the Study:

  • To compare the efficacy and safety of paricalcitol versus calcitriol for SHPT in pediatric dialysis patients.
  • To evaluate treatment outcomes including intact parathyroid hormone (iPTH) levels and calcium x phosphorus product (CaxP).

Main Methods:

  • A study involving 21 pediatric dialysis patients with SHPT.
  • Patients were treated with either calcitriol followed by paricalcitol, or calcitriol/paricalcitol alone.
  • Intact parathyroid hormone (iPTH) levels and calcium x phosphorus product (CaxP) were monitored.

Main Results:

  • Both calcitriol and paricalcitol demonstrated similar reductions in iPTH levels (approximately -60% to -65%).
  • Episodes of hypercalcemia were comparable between groups.
  • Elevated CaxP (> or =70 mg(2)/dl(2)) occurred more frequently with calcitriol treatment (odds ratio=1.5; p=0.01).

Conclusions:

  • Paricalcitol is a safe and effective treatment option for SHPT in pediatric dialysis patients.
  • Dosing of paricalcitol should be individualized based on SHPT severity.
  • Further pharmacokinetic studies in pediatric populations are warranted.

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