الفهرس 
Mineral bone disorder in chronic kidney diseaseOnly 14 pages are availabe for public view
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Abstract
Background: Secondary hyperparathyroidism (SHPT) is one of the components of chronic kidney disease–mineral bone disorder (CKD-MBD) with significant contribution to the morbidity and mortality among prevalent hemodialysis (HD) patients.
Objectives :Multicentric experience study to compare the effectiveness of Intravenous (IV) paricalcitol versus oral cinacalcet and oral cinacalcet plus oral alfacalcidol as treatment regimens of secondary hyperparathyroidism (SHPT) among chronic haemodialysis (HD) patients.
Methods: Retrospective observational cohort study, 1year time horizon, 130 prevalent HD patients with SHPT were recruited from three main HD centres in Aljouf region in Saudi Arabia. Patients were divided into 3 groups: group I (50) HD patients were treated by intravenous paricalcitol, group II (50) HD patients who received oral cinacalcet plus oral alfacalcidol, group III ( 30 ) HD patients were on oral cinacalcet. Serum Intact parathyroid hormone , Calcium , Phosphorus and alkaline Phosphatase tests were assessed every 3 months.
Results : 130 (61 (47%) females, (53%) 69 males ) HD patients, mean age 56.30 ± 19.1 years, mean HD duration 4.86±4.15 year .The mean of PTH is significantly reduced in all studied groups (P<0.001). Mean ∆changes in iPTH concentration in group I, II, III was (-242.11±148.75,-225.54±153.91,-254.83±275.17)(P>0.05) respectively with statistical non-significant differences. Increase of CaxPo4 with paricalcitol group as mean ∆Change in (CaxPO4) was in the group I, II, III(15.39±9.46,1.97±11.74,-2.89 ±9.37) respectively (P<0.001). Significant increase in serum phosphorus from the baseline in patients in group II.
Conclusions: Intravenous Paricalcitol based regimen assumed to be equally effective in suppressing SHPT in prevalent hemodialysis patients when compared to the combination of oral Cinacalcet with oral alfacalcidol or treatment with oral cinacalcet alone , with less incidence of hyperphosphatemia with paricalcitol or cinacalcet in comparison to alfacalcidol regimen.