The efficacy of combined treatment of secondary hyperthyroidism in pre-dialysis chronic kidney disease patients

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Abstract

Background. It is well known that chronic kidney di­sease (CKD) patients develop mineral and bone disturbances which lead to the development of renal osteodystrophy and its complications. Secondary hyperthyroidism is the main reason for the deve­lopment of mineral and bone disoders in these patients. The purpose of the study was to evaluate the efficacy of combined therapy with Alfacalcidol and Quercetin in the treatment of secondary hyperthyroidism in pre-dialysis CKD patients. Materials and me­thods. 61 patients with CKD 3 and 4 stages aged 20–78 years were included in the study. Patients were divided into 2 groups: 35 patients received combined treatment with Alfacalcidol and Quercetin granules, and 26 patients received standard treatment with calcium carbonate. Indices of calcium, phosphorus, magnesium, and alkaline phosphatase were analyzed by photocolometry method and parathyroid hormone (PTH) by immune assay method. Statistical analysis was performed in the Statistica 5.0 program (StatSoft Inc., USA). Results. It was shown that intake of Alfacalcidol (0,25–0,5 mcg daily) and Quercetin granules 1.0 g three times per day provided normalization of calcium-phosphorous homeostasis, correction of hyperthyroidism but also has pronounced analgesic effect as compared with patients receiving monotherapy with calcium carbonate. Conclusions. Combined treatment with Alfacalcidol and Quercetin granules in predialysis CKD patients with se­condary hyperthyroidism leads to calcium and phosphorus metabolism normalization, correction of secondary hyperthyroidism, and has an analgesic effect.
综合治疗透析前慢性肾病患者继发性甲状腺功能亢进的疗效观察
背景。众所周知,慢性肾病(CKD)患者会出现矿物质和骨骼紊乱,从而导致肾性骨营养不良及其并发症的发展。继发性甲状腺机能亢进是这些患者发生矿物质和骨骼疾病的主要原因。本研究的目的是评价阿法骨化醇和槲皮素联合治疗透析前CKD患者继发性甲状腺功能亢进的疗效。材料和方法。61例年龄在20-78岁的CKD 3期和4期患者被纳入研究。患者分为两组:35例患者采用阿法骨化醇、槲皮素颗粒联合治疗,26例患者采用碳酸钙标准治疗。光比色法测定钙、磷、镁、碱性磷酸酶指标,免疫分析法测定甲状旁腺激素(PTH)。统计分析采用Statistica 5.0软件(StatSoft Inc., USA)。结果。研究表明,与接受碳酸钙单药治疗的患者相比,每天摄入阿法骨化醇(0.25 - 0.5微克)和槲皮素颗粒1.0克,每天三次,可使钙磷稳态正常化,纠正甲亢,但也有明显的镇痛作用。结论。阿法骨化醇、槲皮素颗粒联合治疗透析前CKD伴继发性甲亢患者可使钙、磷代谢正常化,纠正继发性甲亢,并有镇痛作用。
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