[Treatment of secondary hyperparathyroidism with vitamin D metabolites]

The aim of this double blind, comparative, randomized study was to eveluate the efficacy of treatment with 1-alpha-OHD3 plus 24,25(OH)2D3 in patients with secondary hyperparathyroidism.A group of 46 patients, 26 females and 20 males, aged 19-67, on chronic haemodialysis, was examined. During the first three months of therapy 0.25 mcg/day 1-alpha-OHD3 was given, and next three months 23 patients were treated with combination of 0.25 mcg/day 1-alpha-OHD3 plus 10 mcg/day 24,25(OH)2D3, and 20 patients recieved 1-alpha-OHD3 plus placebo. Plasma levels of calcium, phosphorus and alkaline phosphatease were measured every two weeks, but PTH and vitamin D metabolites before and eash three months of treatment. At the beginning of investigation all patients had high PTH levels, 25 had high levels of alkaline phosphatase and decreased or unmeasurable concentrations of vitamin D metabolites. Three months later 1,25(OH)2D3 was normal and at the end of the study 24,25(OH)2D3 reached normal value in the group with 24,25(OH)2D3 therapy. During the therapy changes of calcium and phosphorus levels were not significant in both groups, but they were statistically significant only in the group treated with both metabolites. Thus, the study is a good proof of efficacy and usefullnes of 1-alfa-OHD3 plus 24,25 (OH)2D3 regimen recommended.