Velentzas C, Oreopoulos D G, Pierratos A, Meema H E, Rabinovich S, Meindok H, Husdan H, Murray T M, Ogilvie R, Katirtzoglou A
Can Med Assoc J. 1981 Mar 1;124(5):577-83.
Nine patients with renal osteodystrophy were tested for 6.5 to 35 months with 1,25-dihydroxycholecalciferol (1,25-DHCC). A close biochemical follow-up was performed during the first 6 months of treatment, including biweekly determinations of serum calcium, phosphorus, magnesium, alkaline phosphatase and creatinine levels. A bone biopsy, radiologic investigations and determinations of plasma levels of immunoreactive parathyroid hormone (IPTH) and intestinal absorption of calcium 47 were performed before and after the 6 months. Although the five patients with osteitis fibrosa showed a significant improvement, the four with predominantly osteomalacic lesions showed no response to treatment. These four had a normal initial plasma iPTH level, higher serum calcium levels than the other five patients, extreme sensitivity to 1,25-DHCC, with frequent episodes of hypercalcemia, and only a slightly increased serum alkaline phosphatase level, which remained unchanged during treatment. All but one of the patients, irrespective of the histologic abnormality, showed a decrease in the uptake of radionuclide by bone after treatment. The renal function of one patient, a man with long-standing stable renal failure who had not undergone dialysis, deteriorated during treatment.
9例肾性骨营养不良患者接受1,25 - 二羟胆钙化醇（1,25 - DHCC）治疗6.5至35个月。在治疗的前6个月进行了密切的生化随访，包括每两周测定血清钙、磷、镁、碱性磷酸酶和肌酐水平。在6个月前后进行了骨活检、放射学检查以及免疫反应性甲状旁腺激素（IPTH）血浆水平测定和钙47的肠道吸收测定。尽管5例纤维性骨炎患者有显著改善，但4例以骨软化病变为主的患者对治疗无反应。这4例患者初始血浆iPTH水平正常，血清钙水平高于其他5例患者，对1,25 - DHCC极度敏感，频繁发生高钙血症，血清碱性磷酸酶水平仅略有升高，且在治疗期间保持不变。除1例患者外，所有患者无论组织学异常情况如何，治疗后骨对放射性核素的摄取均减少。1例患有长期稳定肾衰竭且未接受透析的男性患者，其肾功能在治疗期间恶化。
