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Published in: Pediatric Nephrology 10/2006

01-10-2006 | Original Article

Paricalcitol versus calcitriol treatment for hyperparathyroidism in pediatric hemodialysis patients

Authors: Wacharee Seeherunvong, Obioma Nwobi, Carolyn L. Abitbol, Jayanthi Chandar, José Strauss, Gastón Zilleruelo

Published in: Pediatric Nephrology | Issue 10/2006

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Abstract

Secondary hyperparathyroidism (SHPT) remains a treatment dilemma in pediatric dialysis patients. Recent experience with paricalcitol (P), a vitamin D analogue, in adults with SHPT has shown equal efficacy and improved survival compared to traditional treatment with calcitriol (C). We present our experience with (C) compared to (P) treatment in our pediatric dialysis patients with SHPT. Twenty-one patients (mean age 11.5±5 years) with SHPT (intact parathyroid hormone (iPTH) averaging 1,228±496 pg/ml) were studied. Seventeen received (C) followed by (P); while an additional four were treated with either (C=1) or (P=3) alone. After 26±8 weeks, average percent (%) decrease in iPTH was similar with (C) and (P) (−60.4±34% versus −65.4±28%, respectively; p=0.6). In the (P) group, the effective dose in children was greater than in adult trials based on kilogram weight. Episodes of hypercalcemia between the treatment groups were not different. However, episodes of elevated calcium × phosphorus product (Ca×P)≥70 mg2/dl2 occurred more frequently in the (C) group (odds ratio=1.5; p=0.01). Paricalcitol appears to be safe and effective in pediatric patients. Data suggest that dosing should be gauged according to degree of SHPT. This should serve as impetus for future pharmacokinetic studies in pediatric dialysis patients.
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Metadata
Title
Paricalcitol versus calcitriol treatment for hyperparathyroidism in pediatric hemodialysis patients
Authors
Wacharee Seeherunvong
Obioma Nwobi
Carolyn L. Abitbol
Jayanthi Chandar
José Strauss
Gastón Zilleruelo
Publication date
01-10-2006
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 10/2006
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-006-0204-5

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