Phosphate and 1α-hydroxyvitamin D3 therapy in haemodialysis patients

A. M. Davison, Munro Peacock, G. S. Walker

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Abstract

39 adult patients on maintenance haemodialysis were treated with 1α-hydroxyvitamin D3 for 8 months. 20 patients (Group I) were treated without concurrent aluminium hydroxide therapy, and 19 patients (Group II) were given aluminium hydroxide to achieve a pre-dialysis plasma phosphate of 1.60 mmol/l or less. There was malabsorption of calcium and phosphorus in both groups. The radiocalcium absorption in Group II did not increase after reduction of plasma phosphate with aluminium hydroxide. In Group I higher doses of 1α-hydroxyvitamin D3 were required as compared to Group II to increase calcium absorption to normal without causing hypercalcaemia above 3 mmol/l. The plasma calcium increased from a mean value of 2.65 mmol/l to 2.90 mmol/l after 1α-hydroxyvitamin D3 therapy in Group I, while in Group II it rose from 2.66 mmol/l to 2.69 mmol/l after phosphate reduction and then to 2.87 mmol/l on 1α-hydroxyvitamin D3. The plasma calcium in Group I and II was not significantly different after 8 months therapy. The plasma phosphate in Group II showed no significant change during the 8 months. There was considerable increase in corneal calcification, pruritus and soft tissue calcification in Group I on 1α-hydroxyvitamin D3 while in Group II there was little increase. The difference in these parameters of metastatic calcification was attributed to the higher plasma phosphate in Group I. Resolution of sub-periosteal erosions occurred in 7 of 11 patients in Group I and only 4 of 9 in Group II. Periosteal new bone formation developed in 6 patients in Group I and none in Group II.

Original languageEnglish (US)
JournalClinical Endocrinology
VolumeVol 7, suppl.
StatePublished - 1977
Externally publishedYes

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Renal Dialysis
Phosphates
Aluminum Hydroxide
Calcium
Therapeutics
Hypercalcemia
Pruritus
Group Psychotherapy
Osteogenesis
Phosphorus
Dialysis
Maintenance

ASJC Scopus subject areas

  • Endocrinology

Cite this

Phosphate and 1α-hydroxyvitamin D3 therapy in haemodialysis patients. / Davison, A. M.; Peacock, Munro; Walker, G. S.

In: Clinical Endocrinology, Vol. Vol 7, suppl., 1977.

Research output: Contribution to journalArticle

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N2 - 39 adult patients on maintenance haemodialysis were treated with 1α-hydroxyvitamin D3 for 8 months. 20 patients (Group I) were treated without concurrent aluminium hydroxide therapy, and 19 patients (Group II) were given aluminium hydroxide to achieve a pre-dialysis plasma phosphate of 1.60 mmol/l or less. There was malabsorption of calcium and phosphorus in both groups. The radiocalcium absorption in Group II did not increase after reduction of plasma phosphate with aluminium hydroxide. In Group I higher doses of 1α-hydroxyvitamin D3 were required as compared to Group II to increase calcium absorption to normal without causing hypercalcaemia above 3 mmol/l. The plasma calcium increased from a mean value of 2.65 mmol/l to 2.90 mmol/l after 1α-hydroxyvitamin D3 therapy in Group I, while in Group II it rose from 2.66 mmol/l to 2.69 mmol/l after phosphate reduction and then to 2.87 mmol/l on 1α-hydroxyvitamin D3. The plasma calcium in Group I and II was not significantly different after 8 months therapy. The plasma phosphate in Group II showed no significant change during the 8 months. There was considerable increase in corneal calcification, pruritus and soft tissue calcification in Group I on 1α-hydroxyvitamin D3 while in Group II there was little increase. The difference in these parameters of metastatic calcification was attributed to the higher plasma phosphate in Group I. Resolution of sub-periosteal erosions occurred in 7 of 11 patients in Group I and only 4 of 9 in Group II. Periosteal new bone formation developed in 6 patients in Group I and none in Group II.

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