Prophylactic 1alpha-hydroxyvitamin D3 therapy in haemodialysis patients

Twenty-seven patients starting regular haemodialysis were treated with a 1 microgram daily dose of 1alpha-hydroxyvitamin D3 and concurrent aluminium hydroxide therapy to prevent hyperphosphataemia. There was an increase in plasma calcium, but no significant improvement in plasma alkaline phosphatase activity or parathyroid hormone levels. Metastatic calcification progressed but was never a severe clinical problem. Quantitative bone histology showed a significant decrease in resorptive surfaces confirmed radiologically, but there was no significant decrease in forming surfaces. The expected increase in forming surfaces with length of dialysis was however prevented.