Oral paricalcitol reduces the prevalence of posttransplant hyperparathyroidism: results of an open label randomized trial.
Amer H, Griffin MD, et al.American Journal of Transplantation 2013; 13(6):1576-85
Aims
To investigate the effect of oral paricalcitol in reducing the incidence of hyperparathyroidism in kidney transplant patients.
Interventions
Patients in the treatment group were administered paricalcitol 1µg/day orally on the third day post transplant. If hypercalcemia did not develop the dose was increased on day 15 post transplant to 2µg/day orally. Calcium carbonate supplement was administered twice a day to patients in both groups. The control group received no additional therapy.
Participants
100 adult kidney transplant recipients.
Outcomes
The primary endpoint was hyperthyroidism 1 year post transplant.
Follow-up
1 year.
CET Conclusions
Oral Paracalcitol (2micrograms daily) was associated with reduced incidence of hyperparathyroidism at one year after renal transplantation. Mild hypercalcaemia occurred in more patients receiving paracalcitol, permitting discontinuation of calcium supplementation. Urinary calcium excretion was increased in patients receiving paracalcitol but no clinical or histological urolithiasis was observed. Bone density in both groups increased after transplantation. There were no differences in renal function. Paracalcitol was associated with more adverse events including general symptoms, vascular events and infectious complications.
Data analysis
Strict intention-to-treat analysis
Trial registration
ClinicalTrials.gov – NCT00587158