Research Article

Double-blind trial of oral 1,25-dihydroxy vitamin D3 versus placebo in asymptomatic hyperparathyroidism in patients receiving maintenance haemodialysis.

Br Med J (Clin Res Ed) 1981; 282 doi: https://doi.org/10.1136/bmj.282.6280.1919 (Published 13 June 1981) Cite this as: Br Med J (Clin Res Ed) 1981;282:1919
  1. D E Memmos,
  2. J B Eastwood,
  3. L B Talner,
  4. P E Gower,
  5. J R Curtis,
  6. M E Phillips,
  7. G D Carter,
  8. J Alaghband-Zadeh,
  9. A P Roberts,
  10. H E de Wardener

    Abstract

    Fifty-seven patients who had been receiving maintenance haemodialysis for a mean of 4.6 years were given 0.25-0.5 microgram oral 1,25-dihydroxy (1,25-(OH)2) vitamin D3 or a placebo in a double-blind manner for one to two years. In patients with normal radiographs (mean plasma parathyroid hormone concentration 205 microliterEq/ml) 1,25-(OH)2 vitamin D3 prevented the development of the radiological appearances of hyperparathyroidism. In patients with abnormal radiographs (mean plasma parathyroid concentration 709 microliterEq/ml) 1,25-(OH)2 vitamin D3 arrested or reversed the radiological changes of hyperparathyroidism. Nevertheless, the response was slow and the concentration of the hormone remained considerably raised (mean 445 microliterEq/ml). It is concluded from these results that giving 1,25-(OH)2 vitamin D3 to patients receiving maintenance haemodialysis who have normal hand radiographs or minimal erosions is beneficial. In patients with more advanced hyperparathyroidism parathyroidectomy should be considered unless there is a rapid response.