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The effect of intravenous 1 alpha(OH)D3 on circulating intact parathyroid hormone (PTH) and COOH-terminal immunoreactive PTH was examined in 21 patients on chronic hemodialysis. The patients were treated for 3 months with increasing doses of 1 alpha(OH)D3 under careful control of serum Ca2+. 1 alpha(OH)D3 was given intravenously at doses of up to 4 micrograms three times a week, and blood samples were obtained every week, including 1 week before treatment (basal control). No patients were treated with oral vitamin D metabolites. At the end of the study intact PTH levels were reduced by an average of 67 +/- 6%, and COOH-terminal immunoreactive PTH levels were reduced by 35 +/- 6%. Serum Ca2+ was kept within normal levels, but showed a slight increase from 1.17 to 1.30 mmol/l. An effect of calcium on PTH secretion could not be excluded, but an effect of 1 alpha(OH)D3, independent of serum Ca2+ was also found. This effect may be mediated by 1,25(OH)2D3, assuming a large capacity of the 25-hydroxylase in the liver to convert 1 alpha(OH)D3 to 1,25(OH)2D3. Also, the parathyroid glands may possess receptors for 1 alpha(OH)D3 with an effect similar to that established for the 1,25(OH)2D3 receptors. Thus, although the exact mechanisms of the action of 1 alpha(OH)D3 have not yet been completely clarified, it is concluded that intravenous administration of 1 alpha(OH)D3 may be of benefit in the treatment of secondary hyperparathyroidism of uremia.
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
February 1991,
Clinical nephrology,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
June 1994,
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
October 1994,
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
October 1990,
Nihon Jinzo Gakkai shi,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
January 1980,
Minerva nefrologica,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
May 1984,
Artificial organs,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
November 1982,
The Tokai journal of experimental and clinical medicine,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
January 1988,
Nephron,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
January 1994,
Mineral and electrolyte metabolism,
L Brandi, and
H Daugaard, and
E Tvedegaard, and
T Storm, and
K Olgaard
February 1985,
Clinical nephrology,
