Paricalcitol therapy: practical experience

Abstract

Mineral bone disease in chronic kidney disease is associated with increased morbidity, decreased quality of life, and heightened mortality. Paricalcitol is potentially able to reduce such complications. There were examined 20 chronically dialyzed patients (9 women and 11 men) with PTH values > 85 pmol/l (> 800 pg/ml) (normal values: 10-85 pg/ml) in 2019 in Chisinau 1 Dialysis Department. Paricalcitol (Paricalcitol) was administered to these patients for 12 weeks in dose equal to 20 mcg/week i.v. There were dynamically determined corresponding biochemical changes in phospho-calcium metabolism. PTH levels: initial 151,36±16,94 pmol/l - final 104,11±19,00 mmol/l (Sign test: p≈0,0008; Wilcoxon test: p≈0,0006). In 18 (90%) patients there were observed PTH reduction following this treatment, including in 40% cases - by more than 50 pmol/l (470 pg/ml). Lack of PTH reduction was recorded only in 10% patients with initial PTH values above 200 pmol/l. Probably, the administered dose was not enough. Statistical evaluation demonstrated the presence of an inverse correlation between baseline PTH values and PTH reduction under treatment with Paricalcitol fixed dose 20 mcg i.v./week. Total serum calcium levels: initial 2.57±0.04 mmol/l - final 2.59±0.06 mmol/l (p>0.05). Alkaline phosphatase levels: initial 205.4±38.73 IU/l - final 189.0±40.03 IU/l (p>0.05). I.v. administration of Paricalcitol demonstrated high efficacy with normalization of PTH values in one third of patients and their reduction in 90% of patients in the treated group.