The effect of a predialysis calcitriol administration protocol on postdialysis parathyroid hormone levels

Patients with chronic kidney disease often develop secondary hyperparathyroidism because of decreases in 1,25(OH)(2)-vitamin D (calcitriol) levels. These changes may be ameliorated with appropriate administration of oral calcitriol during the predialysis period. A calcitriol administration protocol was used with patients beginning on June 1, 2001. Mean serum intact parathyroid hormone (iPTH), calcium, and phosphorous levels from the three months preceding and three months following initiation of dialysis were measured. A significant difference in iPTH levels between patients treated under the calcitriol protocol and patients in the control group was observed. In addition, patients treated under the protocol were more likely to receive calcitriol than those who were not. No significant difference in serum calcium or phosphorous levels was observed. Administration of calcitriol via a protocol in predialysis patients reduced iPTH levels among patients after the initiation of dialysis.