Effect of alfacalcidol on renal bone disease in mild to moderate renal failure

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.6997.124a (Published 08 July 1995) Cite this as: BMJ 1995;311:124
  1. Mark S Mcgregor,
  2. Peter A Rowe,
  3. Brian J R Junor
  1. Clinical research fellow Senior registrar Consultant nephrologist Renal Unit, Wetern Infirmary, Glasgow G11 6NT

    Monitoring the calcium-phosphate product is important

    EDITOR,--In Neveen A T Hamdy and colleagues' study of alfacalcidol in chronic renal failure, treatment with phosphate binding agents (other than 500 mg elemental calcium daily) was started only if the serum phosphate concentration was >2.2 mmol/l.1 We believe that the threshold for starting phosphate binding agents should be lower, particularly when alfacalcidol is being given to “maintain serum calcium concentration at the upper limit of the normal laboratory reference range” (2.63 mmol/l).

    Metastatic calcification has long been recognised as a complication …

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