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Thirty-five patients with bone disease and chronic renal failure (twenty-four on maintenance haemodialysis) were treated for 7--39 months with 1alpha-hydroxyvitamin D3, 2--2.5 microgram daily by mouth. Symptoms (bone pain and muscle weakness) and radiographic appearances improved and plasma alkaline phosphatase returned to normal in the majority of patients (87, 76 and 75% respectively). In contrast, histological appearances in bone improved in only 46% twenty-three patients from whom paired biopsies were available, and this change was not greatly different from that seen in a comparable group of untreated patients. Significant correlations were noted in individual patients between the changes in symptoms, X-rays, plasma alkaline phosphatase and immunoreactive parathyroid hormone and these, in turn, were related to histological changes in bone, although these latter changes were often small. It is concluded that 1alpha-hydroxyvitamin D3 is a useful new drug in the treatment of renal bone disease, but that the evaluation of the response depends critically on the method of assessment used.

Original publication

DOI

10.1111/j.1365-2265.1977.tb03361.x

Type

Journal article

Journal

Clinical endocrinology

Publication Date

12/1977

Volume

7 Suppl

Pages

45s - 50s

Keywords

Ilium, Humans, Renal Osteodystrophy, Hydroxycholecalciferols, Parathyroid Hormone, Alkaline Phosphatase, Renal Dialysis, Adolescent, Adult, Middle Aged, Child, Female, Male