Ruifang Song, Fadong Chen, Zengqi Xue, Xiaozhen Lu
The Third Affiliated Hospital of Wenzhou Medical University, Department of Nephrology, Ruian, China.
J Med Biochem. 2025 Jul 4;44(4):759-769. doi: 10.5937/jomb0-55510.
This study aimed to evaluate the effect of combining paricalcitol with cinacalcet on the levels of intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP) in patients with secondary hyperparathyroidism undergoing maintenance hemodialysis (MHD).
A retrospective analysis was conducted on the clinical records of 129 patients diagnosed with chronic kidney disease (CKD) and secondary hyperparathyroidism who received MHD between June and December 2022. The patients were categorised into three groups based on their treatment regimen: Group A (paricalcitol alone, n=43), Group B (cinacalcet alone, n=43), and Group C (combined paricalcitol and cinacalcet, n=43). Hemoglobin (Hb), serum albumin (Alb), calcium (Ca), phosphorus (P), iPTH, ALP, serum creatinine (Scr), and blood urea nitrogen (BUN) levels were measured at admission, 1 day, 3 months, and 6 months to compare the outcomes across the three groups.
No significant differences among the groups were observed in Hb and Alb levels at 1 day post-admission (P>0.05). However, after 3 and 6 months of treatment, Hb and Alb levels increased in all groups, with Group C showing the greatest improvement (P<0.05). iPTH, Ca, and P levels were similar across all groups on day 1 (P>0.05), but by 3 and 6 months, all groups showed reductions, with Group C having the lowest levels (P<0.05). Similarly, ALP, Scr, and BUN levels decreased in all groups over time, with Group C again demonstrating the greatest reduction (P<0.05).
The combination of paricalcitol and cinacalcet was effective in reducing iPTH, calcium, phosphorus, and ALP and improving Hb and Alb levels in patients with secondary hyperparathyroidism on maintenance hemodialysis. This treatment approach offers significant benefits in managing SHPT.
本研究旨在评估帕立骨化醇与西那卡塞联合使用对维持性血液透析（MHD）的继发性甲状旁腺功能亢进患者血清全段甲状旁腺激素（iPTH）和碱性磷酸酶（ALP）水平的影响。
对2022年6月至12月期间接受MHD治疗的129例诊断为慢性肾脏病（CKD）和继发性甲状旁腺功能亢进的患者的临床记录进行回顾性分析。根据治疗方案将患者分为三组：A组（仅使用帕立骨化醇，n = 43）、B组（仅使用西那卡塞，n = 43）和C组（帕立骨化醇与西那卡塞联合使用，n = 43）。在入院时、1天、3个月和6个月时测量血红蛋白（Hb）、血清白蛋白（Alb）、钙（Ca）、磷（P）、iPTH、ALP、血清肌酐（Scr）和血尿素氮（BUN）水平，以比较三组的治疗结果。
入院后1天，各组间Hb和Alb水平无显著差异（P > 0.05）。然而，治疗3个月和6个月后，所有组的Hb和Alb水平均升高，C组改善最为明显（P < 0.05）。第1天时，所有组的iPTH、Ca和P水平相似（P > 0.05），但到3个月和6个月时，所有组均下降，C组水平最低（P < 0.05）。同样，随着时间的推移，所有组的ALP、Scr和BUN水平均下降，C组下降幅度最大（P < 0.05）。
帕立骨化醇与西那卡塞联合使用可有效降低维持性血液透析的继发性甲状旁腺功能亢进患者的iPTH、钙、磷和ALP水平，并提高Hb和Alb水平。这种治疗方法在管理SHPT方面具有显著益处。
