Questions remain over alfacalcidol's efficacy in preventing secondary hyperparathyroidism

doi:10.1136/bmj.311.6997.124b

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A Fournier,
R Oprisiu,
N E L Esper,
P Moriniere,
A Marie

Professor Attached doctor Hospital practitioners Centre Hospitalier Universitaire d'Amiens, Salouel, 80054 Amiens Cedex 1, France

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. …