ABSTRACT
PURPOSE: In hemodialysis patients with secondary hyperparathyroidism, intravenous administration of calcitriol became widely utilized. In CAPD patients, however, the intravenous administration of calcitriol is not practical. The purpose of the present study was to determine the effect and safety of intraperitoneal (IP) calcitriol pulse therapy in CAPD patients. METHODS: All patients undergoing CAPD between January 2006 and January 2007 and willing to give informed consent were eligible. Inclusion criteria were age greater 18 years, on CAPD for at least 6 months, and secondary hyperparathyroidism (intact PTH >300 pg/mL). Intraperitoneal calcitriol was given by direct infusion into the dialysate (2.0 microgram) twice per week. If hypercalcemia (>10.5 mg/dL) and hyperphosphatemia (>6.5 mg/dL) developed, the patients were excluded from study. RESULTS: Eighteen patients were enrolled into the study. Among them, 16 patients completed the study period. After IP calcitriol for 3 months, there was a significant drop of iPTH level from the pretreatment level of 490+/-234 pg/mL to the level of 318+/-315 pg/mL (p<0.05). There were no definite hypercalcemia during the study period, and only 1 patient was excluded from study due to hyperphosphatemia. CONCLUSION: In CAPD patients, IP calcitriol pulse therapy is effective in treating secondary hyperparathyroidism, and that IP calcitriol pulse therapy is associated with a low incidence of hypercalcemia and hyperphosphatemia.