Winney R J, Tothill P, Robson J S, Abbot S R, Lidgard G P, Cameron E H, Smith M A, Macpherson H N, Strong J A
Clin Endocrinol (Oxf). 1977 Dec;7 Suppl:151s-158s. doi: 10.1111/j.1365-2265.1977.tb03376.x.
The response of hyperparathyroidism and skeletal calcium loss in haemodialysis patients to treatment with 1alpha-hydroxyvitamin D3 and a dialysate calcium concentration of 1.375 mmol/l was compared with the response to treatment with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone over a 6 month period. In patients treated with 1alpha-hydroxyvitamin D3 there was a significant rise in plasma calcium associated with a significant fall in plasma alkaline phosphatase and plasma parathyroid hormone as well as resolution of sub-periosteal erosions. In these patients there was a significant rise in the calcium content of the forearm assessed by neutron activation analysis in comparison to patients treated with a dialysate calcium concentration of 1.75 or 1.375 mmol/l alone. In patients treated with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone there was no significant change in the plasma calcium, alkaline phosphatase or parathyroid hormone after 6 months and in these patients subperiosteal erosions either did not change or became worse. No significant difference in the response in these two groups was observed. This study indicates that treatment of haemodialysis patients with 1alpha-hydroxyvitamin D3 is significantly more effective than treatment with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone in preventing progression of hyperparathyroidism and skeletal calcium loss.
在6个月的时间里，比较了血液透析患者甲状旁腺功能亢进和骨骼钙流失对1α-羟基维生素D3及透析液钙浓度为1.375 mmol/l治疗的反应，与单独使用透析液钙浓度为1.375或1.75 mmol/l治疗的反应。接受1α-羟基维生素D3治疗的患者血浆钙显著升高，同时血浆碱性磷酸酶和血浆甲状旁腺激素显著下降，骨膜下侵蚀也得到缓解。与单独使用透析液钙浓度为1.75或1.375 mmol/l治疗的患者相比，通过中子活化分析评估，这些患者前臂的钙含量显著增加。单独使用透析液钙浓度为1.375或1.75 mmol/l治疗的患者，6个月后血浆钙、碱性磷酸酶或甲状旁腺激素无显著变化，这些患者的骨膜下侵蚀要么没有变化，要么恶化。两组的反应未观察到显著差异。这项研究表明，在预防甲状旁腺功能亢进和骨骼钙流失进展方面，用1α-羟基维生素D3治疗血液透析患者比单独使用透析液钙浓度为1.375或1.75 mmol/l治疗显著更有效。
