Skeletal abnormalities and plasma immunoreactive parathyroid hormone (iPTH) levels were evaluated in eight patients with uremic osteodystrophy treated with 1,25-dihydroxycholecalciferol (1,25-(OH)2D3), 0.14μg to 0.68μg/day, for 8 to 17 weeks. Serum calcium levels increased in all but exceeded 10 mg/100 ml in only three; serum phosphorus level changes were small and variable. Plasma iPTH levels decreased noticeably in six patients, reaching normal values in two. Bone biopsies showed reduction in resorptive surface in four patients with skeletal lesions primarily of secondary hyperparathyroidism; in one, marrow fibrosis decreased from 11.5% to 0.3%. In four persons with osteomalacic lesions predominating, osteoid width was reduced slightly in three and calcification front improved in two. Observations indicate that administration of small quantities of 1,25-(OH)2D3to uremic patients can markedly reverse hyperparathyroid manifestations and improve lesions of osteomalacia.
Brickman AS, Sherrard DJ, Jowsey J, et al. 1,25-Dihydroxycholecalciferol: Effect on Skeletal Lesions and Plasma Parathyroid Hormone Levels in Uremic Osteodystrophy. Arch Intern Med. 1974;134(5):883–888. doi:10.1001/archinte.1974.00320230093020
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