Kidney Week

Abstract: PUB216

Intravenous Paricalcitol in Pediatric Patients on Chronic Hemodialysis: A Single-Center Experience

Session Information

• Publication Only

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Vieira, Simone, Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Simone Vieira, MS, MSc

• Carvalho, Maria Fernanda Camargo, Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Maria Fernanda Camargo Carvalho, MD

• Henriques, Cristina Lucia, Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Cristina Lucia Henriques, MD

• Pacheco, Pollyanna Santos, Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Pollyanna Santos Pacheco

• Genzani, Camila Penteado, Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Camila Penteado Genzani

• Koch Nogueira, Paulo C., Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Paulo C. Koch Nogueira, MD

Background

Paricalcitol is a synthetic vitamin D analog that suppresses parathyroid hormone (PTH) secretion through selective activation of the vitamin D receptor.
The aim of this study was to evaluate the efficacy, safety, and adverse effects of paricalcitol in pediatric patients undergoing chronic hemodialysis with secondary hyperparathyroidism.

Methods

Serum calcium, phosphorus, parathyroid hormone (PTH), calcium-phosphorus product (Ca × P), and sevelamer dose were evaluated at the initiation of paricalcitol therapy and after 1, 3, 6, and 12 months of treatment. The minimum treatment duration was 3 months. Statistical analysis was performed using linear mixed-effects models (linear prediction).

Results

Thirty patients were included in the study (10 females). Mean age was 4.6 years (range: 8 months–14.2 years). The mean initial paricalcitol dose was 0.72 mcg/kg/vial. The following results were observed: PTH Serum PTH levels decreased significantly, with estimated values declining from 730 pg/mL before treatment initiation to levels ranging from 202 to 365 pg/mL, maintained throughout follow-up. This reduction became statistically significant after the third month of therapy (p = 0.001). Serum calcium: Calcium levels increased after treatment initiation; however, the risk of significant hypercalcemia (Ca >11 mg/dL) was not statistically significant at any time during the study (p = 0.18). Serum phosphorus: Phosphorus levels increased, with a trend toward statistical significance (p = 0.059), although no cases of severe hyperphosphatemia (P >6 mg/dL) were observed. No increase in sevelamer dose was required during follow-up (p = 0.46). Ca × P product: An increase in the calcium-phosphorus product was observed, without statistical significance (p = 0.10).

Conclusion

Paricalcitol was associated with a significant reduction in PTH levels without clinically significant changes in calcium, phosphorus, or Ca × P levels, and without the need for increased sevelamer dosing. These findings suggest that paricalcitol is an effective and safe therapeutic option for pediatric patients undergoing chronic hemodialysis.