Korean Journal of Nephrology 1990;9(4):460-469.

말기 신부전증 환자에서 Rocaltrol ( 1 , 25 - ( OH) 2 cholecalciferol ) 이 골대사에 미치는 영향

최규헌 , 이승우 , 임세중 , 김영기 , 이호영 , 한대석 , 이현철 , 허갑범

Abstract

In order to investigate the efficacy of Rocaltrol, the most active known form of vitamin D, on bone metabolism in dialysis patients, Rocaltrol was tried in 30 maintenance dialysis patients (hemodialysis: 23, con- tinuous ambulatory peritoneal dialysis:7) for 12 weeks, and we evaluated several biochemical and bone par ameters including parathyroid hormone (PTH), metacarpal index (MCI) and bone mineral density (BMD) of lumbar spine were evaluated regularly during therapy. Calcium supplements were not given. Dosage of Rocaltrol and aluminium hydroxide preparations were increased as necessary to keep the plasma calcium concentration above 9.0mg/dl and the phosphorus be- low 6 mg/dl. The following results were obtained: 1) The patients were 22 men and 8 women, and mean age was 42.7 years. 2) Before trial, clinical symptoms were bone pains on lower extremities in 3 patients and pruritus in 2 patients, but those symptoms were disappeared during trial. 3) The plasma calcium concentration measured every 2 weeks, started to rise significantly at the first 2nd week of therapy and maintained to be higher than pre-treatment value during follow-up period. 4) PTH concentration showed significant reduction at 4th week of therapy and maintained below pre- treatment values for remaining follow-up period. 5) At 12 weeks after treatment, BMD utilizing dual photon absorptiometry and MCI were significanlty in- creased from pre-treatment values. 6) Any remarkable changes in hematologic and blood biochemical findings including blood sugar, uric acid, aminotransferase were not noted during therapy. 7) Although there were side effects with short dura- tion such as constipation in 7 patients, nausea in 5, and pruritus in 2 patients, there was no case who stopped mediaction due to side effects. From the above results, it seems that Rocaltrol can be considered as effective agent for improving bone par- ameters including PTH without significant side effects, but further studies for the evaluation of histologic changes and long-term side effects will be needed.