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August 1980

Effects of Long-term Therapy With Calcitriol in Patients With Moderate Renal Failure

Author Affiliations

From the Divisions of Nephrology (Drs Healy, Malluche, Goldstein, and Massry) and Endocrinology (Dr Singer), University of Southern California School of Medicine, Los Angeles.

Arch Intern Med. 1980;140(8):1030-1033. doi:10.1001/archinte.1980.00330190042017

Since abnormalities in divalent ion metabolism occur early in renal insufficiency, treatment of patients with moderate renal failure with calcitriol could halt and/or reverse these disturbances. The effects of long-term treatment with calcitriol (0.5 μ/day) in three such patients were evaluated. Serum calcium level rose from 0.3 to 0.7 mg/dL. Blood parathyroid hormone levels were mildly elevated and fell to normal. Intestinal absorption of calcium increased. The patients had hypocalciuria and the urinary calcium level increased. Creatinine clearance remained stable in all patients. Iliac crest biopsy specimens obtained after double tetracycline hydrochloride labeling revealed mild osteomalacia and hyperparathyroid bone disease that healed after therapy. The data show that a small dose of calcitriol is safe and effective for the management of the derangements of divalent ion metabolism in patients with moderate renal failure.

(Arch Intern Med 140:1030-1033, 1980)