BMJ 1995;311:124 (8 July)

Letters

Questions remain over alfacalcidol's efficacy in preventing secondary hyperparathyroidism

EDITOR,--Neveen A T Hamdy and colleagues report a placebo controlled trial of alfacalcidol in patients with mild to moderate renal failure.1 They conclude that alfacalcidol might be used more widely in these patients. Before we accept their conclusion we would appreciate answers to the following points.

Firstly, since the conclusions are based on histomorphometric data on bone we would like to know the normal ranges for these histomorphometric variables, the criteria used to show that the number of osteoclasts and osteoblasts was increased, and the significance of the difference in the number of bone cells between the two groups at the end of the trial.

Secondly, were the final plasma concentrations of parathyroid hormone significantly different between the two groups? Why was the suppression of secretion of the hormone with alfacalcidol only transient? Might not this escape in the control of secretion of parathyroid hormone lead to a reversal of . . . [Full text of this article]


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Relevant Article

Effect of alfacalcidol on natural course of renal bone disease in mild to moderate renal failure
Neveen A T Hamdy, John A Kanis, Monique N C Beneton, Colin B Brown, Job R Juttmann, Johannes G M Jordans, Sylvie Josse, Alain Meyrier, Robert L Lins, and Ian T Fairey
BMJ 1995 310: 358-363. [Abstract] [Full Text]

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