Coen G, Taccone-Gallucci M, Bonucci E, Bianchini G, Gallucci G, Lucentini G, Matteucci M C, Picca S, Casciani C U
Int J Artif Organs. 1979 Nov;2(6):278-81.
The effects of 25-OHD3 on renal osteodystrophy have been studied in 6 patients on maintenance haemodialysis. Administration of 25-OHD3, 50 microgram/day, did not improve biochemical data and intestinal absorption of calcium. With a dose of 100 microgram/day in all patients an increase in blood calcium levels eventually reaching hypercalcemic values was observed. In two cases a fall in alkaline phosphatase toward normal values was noted. In the same cases the treatment-induced hyperphosphatemia, uncontrolled by AI(OH)3 supplementation and similarly high iPTH levels were observed. In two cases repeated bone biopsy following 8 months treatment and not show substantial improvement of bone lesions. In one case addition of 1,25-(OH)2D3 to the treatment with 25-OHD3 led to a more rapid improvement in biochemical parameters and iPTH serum levels. Doses of 25-OHD3 capable to correct blood calcium levels and intestinal absorption of calcium, may have minimal benefit on the osteitis fibrosa component of the bone lesion.
对6例维持性血液透析患者研究了25-羟维生素D3（25-OHD3）对肾性骨营养不良的影响。每天给予50微克的25-OHD3，并未改善生化指标及钙的肠道吸收。所有患者每天给予100微克剂量时，观察到血钙水平升高，最终达到高钙血症值。2例患者碱性磷酸酶降至正常水平。在相同病例中，观察到治疗引起的高磷血症，补充氢氧化铝（AI(OH)3）无法控制，且甲状旁腺激素（iPTH）水平同样很高。2例患者在治疗8个月后重复进行骨活检，未显示骨病变有实质性改善。1例患者在25-OHD3治疗中加用1,25-二羟维生素D3（1,25-(OH)2D3）后，生化指标和血清iPTH水平改善更快。能够纠正血钙水平及钙肠道吸收的25-OHD3剂量，对骨病变的纤维性骨炎成分可能益处极小。
