Efecto de alfacalcidol en pacientes con hiperparatiroidismo secundario

Abstract

IntroductionThe consequences of elevated parathyroid hormone (PTH) levels are severe and can be life-threatening. ObjectivesTo determine whether the use of high-dose alfacalcidol reduces intact PTH (iPTH) levels in patients un-dergoing hemodialysis twice weekly. MethodsOf all the patients of the Salvadorean Institute of Social Security under hemodialysis in January 2004, those with iPTH levels above 500 μg/ml were included in this study. Oral alfacalcidol was administered at doses of 2 μg twice weekly for 3 months. Subsequently 3 μg were administered twice weekly for 4 further months. ResultsThe one-sample t-test was performed, demon-strating statistically significant differences between initial and final iPTH levels (p=0.0001). The correlation coef-ficient demonstrated that if treatment were initiated in patients with high iPTH values, a greater reduction (84 %) in iPHT would be obtained (p=0.0026). Spearman’s correlation also showed a significant reduction in iPTH levels (p=0.0054). When the one-sample t-test was applied, the reduction in alkaline phosphatase had a p-value of < 0.0001, with a mean reduction of 482. ConclusionsThe use of alfacalcidol at doses higher than 1.25 μg/week in patients under hemodialysis reduces iPTH levels.