Management of renal osteodystrophy with 1,25(OH)₂D₃. I. Effects on clinical, radiographic and biochemical parameters

The effects of 1,25 (OH)₂D₃ on the clinical symptoms, biochemical derangements and X-ray manifestations of renal osteodystrophy were evaluated in 15 dialysis patients. Long-term treatment with this metabolite produced a marked improvement or cure of the weakness and bone pain experienced by these patients. In addition, there was a rise in the serum concentrations of total and ionized calcium and phosphorus in all patients, and a fall in serum levels of iPTH in half of them. There was an inverse correlation between the rise in serum calcium and the percent fall in serum iPTH. The serum levels of alkaline phosphatase fell progressively and returned to normal only after many months of therapy. Mild hypercalcemia occurred frequently and was rapidly controlled by either reducing the dose of 1,25(OH)₂D₃ or discontinuing therapy. There was improvement in X-ray abnormalities in some of the patients after 6 months of therapy. The data indicate that 1,25(OH)₂D₃ provides an efficacious therapeutic modality for the management of the clinical and biochemical abnormalities of renal osteodystrophy.