Calcitriol Administration in End-stage Renal Disease: Intravenous or Oral?

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 1996 Jun 1

PMID 8792399

Citations 1

Authors

L D Quarles

O S Indridason

Affiliations

Soon will be listed here.

Abstract

1,25-Dihydroxyvitamin D deficiency plays an important role in the pathogenesis of secondary hyperparathyroidism, and adequate replacement of this hormone is considered essential to normalize parathyroid gland function and restore bone homeostasis in patients with advanced renal failure. Although initial uncontrolled clinical trials suggested the superiority of intravenous calcitriol treatment, more recent controlled investigations show that different routes (oral versus intravenous), frequency (daily versus intermittent), and dosing (physiological versus pharmacological) of calcitriol administration are clinically equivalent. Overall, the response to calcitriol treatment depends more on the severity of secondary hyperparathyroidism and the presence of confounding variables, such as hyperphosphatemia and acquired abnormalities of parathyroid cell function, than the method of calcitriol administration.

Citing Articles

Comparison of oral and intravenous alfacalcidol in chronic hemodialysis patients.

Lessard M, Ouimet D, LeBlanc M, Nadeau-Fredette A, Bell R, Lafrance J BMC Nephrol. 2014; 15:27.

PMID: 24495277 PMC: 3915223. DOI: 10.1186/1471-2369-15-27.

References

Quarles L, Yohay D, Carroll B, Spritzer C, Minda S, Bartholomay D . Prospective trial of pulse oral versus intravenous calcitriol treatment of hyperparathyroidism in ESRD. Kidney Int. 1994; 45(6):1710-21. DOI: 10.1038/ki.1994.223. View

Joffe P, Cintin C, Ladefoged S, Rasmussen S . Pharmacokinetics of 1 alpha-hydroxycholecalciferol after intraperitoneal, intravenous and oral administration in patients undergoing peritoneal dialysis. Clin Nephrol. 1994; 41(6):364-9. View

Hamdy N, Kanis J, Beneton M, Brown C, Juttmann J, Jordans J . Effect of alfacalcidol on natural course of renal bone disease in mild to moderate renal failure. BMJ. 1995; 310(6976):358-63. PMC: 2548761. DOI: 10.1136/bmj.310.6976.358. View

Mazzaferro S, Pasquali M, Ballanti P, Bonucci E, Di Sanza P, Sardella D . Intravenous versus oral calcitriol therapy in renal osteodystrophy: results of a prospective, pulsed and dose-comparable study. Miner Electrolyte Metab. 1994; 20(3):122-9. View

Koyama H, Nishizawa Y, Inaba M, Hino M, Prahl J, DeLuca H . Impaired homologous upregulation of vitamin D receptor in rats with chronic renal failure. Am J Physiol. 1994; 266(5 Pt 2):F706-12. DOI: 10.1152/ajprenal.1994.266.5.F706. View

Galceran T, Chan Y, Rapp N, Martin K, Slatopolsky E . Hypocalcemia may not be essential for the development of secondary hyperparathyroidism in chronic renal failure. J Clin Invest. 1986; 78(4):1097-102. PMC: 423770. DOI: 10.1172/JCI112666. View

Quarles L, Davidai G, Schwab S, Bartholomay D, Lobaugh B . Oral calcitriol and calcium: efficient therapy for uremic hyperparathyroidism. Kidney Int. 1988; 34(6):840-4. DOI: 10.1038/ki.1988.258. View

Lee W, Padayachi K, Collins J, Cundy T . A comparison of oral and intravenous alfacalcidol in the treatment of uremic hyperparathyroidism. J Am Soc Nephrol. 1994; 5(6):1344-8. DOI: 10.1681/ASN.V561344. View

Liou H, Chiang S, Huang T, Shieh S, Akmal M . Comparative effect of oral or intravenous calcitriol on secondary hyperparathyroidism in chronic hemodialysis patients. Miner Electrolyte Metab. 1994; 20(3):97-102. View

10.

Fukuda N, Tanaka H, Tominaga Y, Fukagawa M, Kurokawa K, Seino Y . Decreased 1,25-dihydroxyvitamin D3 receptor density is associated with a more severe form of parathyroid hyperplasia in chronic uremic patients. J Clin Invest. 1993; 92(3):1436-43. PMC: 288288. DOI: 10.1172/JCI116720. View

11.

Cannella G, Bonucci E, Rolla D, Ballanti P, Moriero E, De Grandi R . Evidence of healing of secondary hyperparathyroidism in chronically hemodialyzed uremic patients treated with long-term intravenous calcitriol. Kidney Int. 1994; 46(4):1124-32. DOI: 10.1038/ki.1994.375. View

12.

Reichel H, Szabo A, Uhl J, Pesian S, Schmutz A, Schmidt-Gayk H . Intermittent versus continuous administration of 1,25-dihydroxyvitamin D3 in experimental renal hyperparathyroidism. Kidney Int. 1993; 44(6):1259-65. DOI: 10.1038/ki.1993.377. View

13.

Coburn J, Salusky I, Norris K, Goodman W . Oral and parenteral calcitriol for the management of end-stage renal disease. Contrib Nephrol. 1991; 90:166-82. DOI: 10.1159/000420140. View

14.

Szabo A, Merke J, Beier E, Mall G, Ritz E . 1,25(OH)2 vitamin D3 inhibits parathyroid cell proliferation in experimental uremia. Kidney Int. 1989; 35(4):1049-56. DOI: 10.1038/ki.1989.89. View

15.

Herrmann P, Ritz E, Schmidt-Gayk H, Schafer I, Geyer J, Nonnast-Daniel B . Comparison of intermittent and continuous oral administration of calcitriol in dialysis patients: a randomized prospective trial. Nephron. 1994; 67(1):48-53. DOI: 10.1159/000187887. View

16.

Arnold A, Brown M, Urena P, Gaz R, Sarfati E, Drueke T . Monoclonality of parathyroid tumors in chronic renal failure and in primary parathyroid hyperplasia. J Clin Invest. 1995; 95(5):2047-53. PMC: 295791. DOI: 10.1172/JCI117890. View

17.

Patel S, Ke H, Vanholder R, Hsu C . Inhibition of nuclear uptake of calcitriol receptor by uremic ultrafiltrate. Kidney Int. 1994; 46(1):129-33. DOI: 10.1038/ki.1994.252. View

18.

Fischer E, Harris D . Comparison of intermittent oral and intravenous calcitriol in hemodialysis patients with secondary hyperparathyroidism. Clin Nephrol. 1993; 40(4):216-20. View

19.

Salusky I, Goodman W, Horst R, Segre G, Kim L, Norris K . Pharmacokinetics of calcitriol in continuous ambulatory and cycling peritoneal dialysis patients. Am J Kidney Dis. 1990; 16(2):126-32. DOI: 10.1016/s0272-6386(12)80566-x. View

20.

Garrett J, Capuano I, Hammerland L, Hung B, Brown E, Hebert S . Molecular cloning and functional expression of human parathyroid calcium receptor cDNAs. J Biol Chem. 1995; 270(21):12919-25. DOI: 10.1074/jbc.270.21.12919. View