This study was undertaken to evaluate high-dose intravenous (IV)
calcitriol therapy in chronic
peritoneal dialysis (PD) patients. Nine stable chronic PD patients (7 male, 2 female, mean age 54 years) with
secondary hyperparathyroidism and a mean duration of PD of 33 months, were studied for 6 months. Pulse
calcitriol was administered IV in dosages of 4-8 micrograms every 2 weeks. Eight patients received oral
calcitriol prior to IV pulse. Five patients were on
continuous ambulatory peritoneal dialysis, and 4 patients were on continuous cycling
peritoneal dialysis. Seven patients were on low-
calcium dialysate (2.5 mEq/L) and 2 on high-
calcium dialysate (3.5 mEq/L). All patients received
calcium acetate or
calcium carbonate to control
hyperphosphatemia during the study. Mean serum
parathyroid hormone N-terminal (PTHN) levels (35.4 +/- 9.5 pg/mL) decreased significantly from premean serum PTHN levels (79.7 +/- 10.4 pg/mL). No significant changes were observed in premean serum total
calcium, ionized
calcium, and
phosphorus levels and posttherapy levels. No correlation was observed between serum PTHN and serum
calcium,
1,25(OH)2D3, serum
aluminum, and duration of dialysis. No significant difference in total body
calcium and total body bone mineral density (BMD) was observed between pre and post study periods. In conclusion, biweekly IV
calcitriol therapy is effective in suppressing
secondary hyperparathyroidism in PD patients.