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Abstract: FR-PO143

Paricalcitol for Severe Secondary Hyperparathyroidism in Hemodialysis Patients

Session Information

Category: Bone and Mineral Metabolism

  • 401 Bone and Mineral Metabolism: Basic

Authors

  • Jimenez Mejia, Carlos Daniel, Universidad de Guadalajara, Aguascalientes, Mexico
  • Topete reyes, Jorge fernando, Universidad de Guadalajara, Aguascalientes, Mexico
  • Soto-Vargas, Javier, Instituto Mexicano Del Seguro Social, Guadalajara, Mexico
  • Aguilar, Arantxa Karina, Universidad de Guadalajara, Aguascalientes, Mexico
  • Villegas, Luz Yareli, Universidad de Guadalajara, Aguascalientes, Mexico
  • Katia yuritzi, Ríos Cornejo, Universidad de Guadalajara, Aguascalientes, Mexico

Group or Team Name

  • Departamento de Nefrologia HGR 46
Background

Severe secondary hyperparatiroidism (SSHP) is associated with renal osteodystrophy, extraosseous calcifications, fractures, and increased mortality in end-stage kidney disease (ESKD) patients, especially those in hemodialysis (HD). Currently, their treatment consists on control of hyperphosphatasemia with phosphate binders, vitamin D or its analogues, as well as calcimimetics to suppress PTH release and ultimately surgery. Our main objective was to determine the effectiveness of paricalcitol to control PTH levels in HD patients with SSHP

Methods

Phase 2 placebo control double blinded trial that included patients with ESKD on HD for more than six months with SSHP resistant to management with calcitriol. The patients were assigned to receive paricalcitol (at dose dependent on their iPTH levels/80) or placebo and conventional treatment with phosphate binders

Results

During March to April 2019 there were screened 650 patients in our center, after application of selection criteria ten patients were allocated to paricalcitol group and nine to the control group. The median PTH level in the paricalcitol group was 1162 pg/ml, while in the placebo group was 925 pg/ml. After one month of treatment, the paricalcitol group had a mean reduction of 798.5 pg, and the control group had a median increase of 179.2 pg (p=0.013). There were no reported adverse effects in either group

Conclusion

Paricalcitol showed an important reduction in PTH levels in patients with SSHP on HD, without increased risk for hyperphosphatemia or other adverse events