[血液透析患者继发性甲状旁腺功能亢进的治疗——特立醇加或不加cinacalcet]。

Przeglad lekarski Pub Date : 2016-01-01
Jacek Zawierucha, Jolanta Małyszko, Jacek Małyszko, Teresa Dryl-Rydzyńska, Tomasz Prystacki, Wojciech Marcinkowski
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引用次数: 0

摘要

继发性甲状旁腺功能亢进(sHPT)是慢性肾脏疾病(CKD)相关代谢紊乱的常见并发症。sHPT的治疗应导致磷酸钙管理稳定和甲状旁腺激素水平降低。磷酸盐结合剂、合成维生素D类似物和煅烧助剂用于sHPT处理。本文对36例血透合并sHPT(血清iPTH> 500 pg/ml)患者进行了为期3个月的特化醇治疗。11例患者另外接受了cinacalcet治疗。分析结果显示iPTH和碱性磷酸酶有统计学意义的降低。Paricalcitol是治疗SHPT的有效药物,副作用少。碱性磷酸酶还原可能是一种理想的附加治疗效果。然而,对于那些在钙化疗法后出现低钙血症的患者,似乎应该给予特立醇和cinacalcet联合治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Treatment of secondary hyperparathyroidism in hemodialysed patients--paricalcitol with or without cinacalcet].

Secondary hyperparathyroidism (sHPT) is a common complication being a consequence of metabolic disorders associated with chronic kidney disease (CKD). Treatment of the sHPT should lead to calcium-phosphate management stabilization and parathyroid hormone levels reduction. The phosphate binders, synthetic vitamin D analogs and calcimimetics are used in sHPT treatment. In this paper we analyzed the results of three month paricalcitol treatment of 36 hemodialysis patients with sHPT (serum iPTH> 500 pg/ml). 11 patients have additionally received cinacalcet. Analysis of the results showes a statistically significant reduction in iPTH and alkaline phosphatase. Paricalcitol is effecitve in the tratment of SHPT with favourable profile of side effects. Alcaline phosphatase reduction may be a desirable additional therapeuctic effect. However, it appears that combined therapy with paricalcitol and cinacalcet shoud be offered to selected population of patients i.e. with hypocalcemia after calcimimetics.

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