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Intraperitoneal Calcitriol for Treatment of Severe Hyperparathyroidism in Children with Chronic Kidney Disease: A

Rahul Chanchlani1,2,3, Susan Ackerman1, Elizabeth Piva1

  • 1Division of Nephrology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|December 2, 2016
PubMed

Insights

Intraperitoneal calcitriol effectively treats severe secondary hyperparathyroidism in children with chronic kidney disease on peritoneal dialysis (PD) who are resistant to oral Vitamin D. This method offers a convenient alternative for managing mineral bone disease in PD patients.

Area of Science:

  • Nephrology
  • Pediatric Endocrinology
  • Mineral and Bone Disorders

Background:

  • Chronic kidney disease (CKD) often leads to mineral bone disease (MBD) and secondary hyperparathyroidism.
  • Active Vitamin D sterols are standard treatments, but oral formulations can be ineffective in children on peritoneal dialysis (PD).
  • Intravenous (IV) Vitamin D is inconvenient for PD patients, prompting exploration of alternative delivery methods.

Purpose of the Study:

  • To evaluate the efficacy of intraperitoneal (IP) calcitriol in treating severe secondary hyperparathyroidism in children with CKD on PD.
  • To highlight IP calcitriol as a viable treatment option for PD patients refractory to oral active Vitamin D.

Main Methods:

  • Case report of two children (aged 1 and 9.5 years) on chronic cycler PD with severe secondary hyperparathyroidism.
  • Treatment with intraperitoneal calcitriol for 12 and 4 months, respectively.
  • Review of published literature on IP calcitriol efficacy in PD patients.

Main Results:

  • Successful treatment of severe secondary hyperparathyroidism in both pediatric patients.
  • Demonstrated efficacy of IP calcitriol in patients resistant to oral active Vitamin D.
  • IP calcitriol provided a convenient and effective therapeutic option.

Conclusions:

  • Intraperitoneal calcitriol is an effective treatment for secondary hyperparathyroidism in children with CKD on PD.
  • This route bypasses oral resistance and offers convenience compared to IV administration.
  • Further consideration of IP calcitriol is warranted for managing MBD in PD patients.

Keywords:
Secondary hyperparathyroidismcalcitriolchronic kidney diseaseperitoneal dialysis

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