Chen X, Zhao F, Pan WJ, Di JM, Xie WN, Yuan L, Liu Z. Paricalcitol in hemodialysis patients with secondary hyperparathyroidism and its potential benefits. World J Clin Cases 2021; 9(33): 10172-10179 [PMID: 34904087 DOI: 10.12998/wjcc.v9.i33.10172]
Corresponding Author of This Article
Zhi Liu, MD, Chief Doctor, Department of Nephrology, The First Affiliated Hospital of Anhui University of Science and Technology (The First People’s Hospital of Huainan), No. 203 Huaibin Road, Tianjiaan District, Huainan 232007, Anhui Province, China. hnsnk@163.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Clinical Trials Study
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Chen X, Zhao F, Pan WJ, Di JM, Xie WN, Yuan L, Liu Z. Paricalcitol in hemodialysis patients with secondary hyperparathyroidism and its potential benefits. World J Clin Cases 2021; 9(33): 10172-10179 [PMID: 34904087 DOI: 10.12998/wjcc.v9.i33.10172]
Xiu Chen, Feng Zhao, Wei-Juan Pan, Jia-Mei Di, Wei-Nan Xie, Ling Yuan, Zhi Liu, Department of Nephrology, The First Affiliated Hospital of Anhui University of Science and Technology (The First People’s Hospital of Huainan), Huainan 232007, Anhui Province, China
Author contributions: Chen X and Liu Z designed the study and drafted the manuscript; Zhao F and Pan WJ collected the data and performed statistical analysis; Di JM and Xie WN participated in the data collection; Yuan L supervised the research and revised the draft; Liu Z participated in language editing of the draft; All authors have read and approved the final manuscript.
Supported by2019 Anhui University Natural Science Research Project, No. KJ2019A0094, No. KJ2019A0095; Huainan City "50 Science and Technology Stars" Innovation Team Project; and Scientific Research Platform of Huainan Science and Technology Bureau, No. 2017G32.
Institutional review board statement: The study was reviewed and approved by The First People's Hospital of Huainan City Institutional Review Board (Approval No.2019-18).
Clinical trial registration statement: This study is not a clinical registration trial.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declared that they have no conflicts of interest to this work.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at hnsnk@163.com. Participants gave informed consent for data sharing.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Corresponding author: Zhi Liu, MD, Chief Doctor, Department of Nephrology, The First Affiliated Hospital of Anhui University of Science and Technology (The First People’s Hospital of Huainan), No. 203 Huaibin Road, Tianjiaan District, Huainan 232007, Anhui Province, China. hnsnk@163.com
Received: July 7, 2021 Peer-review started: July 7, 2021 First decision: July 26, 2021 Revised: August 12, 2021 Accepted: October 14, 2021 Article in press: October 14, 2021 Published online: November 26, 2021 Processing time: 138 Days and 0.1 Hours
ARTICLE HIGHLIGHTS
Research background
Secondary hyperparathyroidism (SHPT) is a common complication in patients with end-stage renal disease. SHPT is a component of chronic kidney disease-mineral and bone disorder, which is featured by increased fibroblast growth factor 23 and serum parathyroid hormone concentrations, decreased 1,25(OH)2 vitamin D concentrations and abnormal serum phosphate and calcium concentrations.
Research motivation
The long-term use of vitamin D receptor activators (VDRAs) may enhance the intestinal absorption of calcium and phosphorus and tubular reabsorption, leading to an increase in serum levels of calcium and phosphorus and risk of vascular calcification. But Paricalcitol mildly affects intestinal calcium and phosphorus absorption. Paricalcitol may be better than VDRAs in this aspect.
Research objectives
This study aimed to discuss the outcome, safety and other potential benefits of paricalcitol injection in hemodialysis patients with SHPT.
Research methods
Total 40 patients who received hemodialysis for chronic renal failure with SHPT received paricalcitol injection for 24 wk, three times per week. The primary outcome indicator was the percentage of patients with a > 30% decrease in intact parathyroid hormone (iPTH) levels at week 24 compared with the baseline.
Research results
After 24 wk of treatment, iPTH levels decreased significantly. More than 30% decrease of iPTH was found in 21 of 36 (58.33%) patients. The average decrease in iPTH levels was 32.16 ± 4.33%; the standard-reaching rate of iPTH levels was 66.67% (24/36); and alkaline phosphatase levels decreased significantly compared with the baseline. There were no significant differences in the serum levels of calcium, hemoglobin, creatinine and C-reactive protein compared with the baseline.
Research conclusions
This study suggested that the paricalcitol was a safe and effective treatment for hemodialysis patients with SHPT.
Research perspectives
Multicenter studies with a larger sample size will be performed to provide evidence for the clinical use of paricalcitol.