Wanic-Kossowska M, Grzegorzewska A, Plotast H, Bombicki K
Department of Nephrology, University School of Medical Sciences, Poznań, Poland.
Perit Dial Int. 1996;16 Suppl 1:S305-8.
The purpose of the present study is to investigate whether calcitriol therapy in uremic patients undergoing dialysis treatment can improve muscle function. In 8 uremic patients [2 on continuous ambulatory peritoneal dialysis (CAPD), 6 on hemodialysis (HD) treatment], calcitriol (Calcitriol, Roche) was given in the dose of 1 microgram/day for 15 months. At the beginning of therapy and every month, the following parameters in serum were determined: creatinine (Cr), calcium (Ca), phosphate (P), and parathyroid hormone (PTH). At the beginning and at the end of treatment, quantitative electromyography (EMG) was performed. We observed a slight increase of serum Cr during 15 months of treatment in 4 patients. Serum Ca, P, and PTH did not change significantly. The EMG revealed abnormal polyphasic motor nerve unit potentials of brief durations, a decrease in the amplitude, and fibrillation potentials. The EMG findings did not change significantly after calcitriol therapy, but all patients on physical examinations exhibited the disappearance of clinical manifestations of uremic myopathy. In conclusion, our findings suggest that vitamin D deficiency is one of the causes of uremic myopathy and a careful treatment with calcitriol can diminish muscle weakness in uremic patients.
本研究的目的是调查接受透析治疗的尿毒症患者使用骨化三醇治疗是否能改善肌肉功能。8例尿毒症患者[2例接受持续性非卧床腹膜透析（CAPD），6例接受血液透析（HD）治疗]，给予骨化三醇（罗钙全，罗氏公司），剂量为1微克/天，持续15个月。在治疗开始时及每月测定血清中的以下参数：肌酐（Cr）、钙（Ca）、磷（P）和甲状旁腺激素（PTH）。在治疗开始和结束时进行定量肌电图（EMG）检查。我们观察到4例患者在15个月的治疗期间血清Cr略有升高。血清Ca、P和PTH无明显变化。肌电图显示运动神经单位电位呈多相性，时限短，波幅降低，出现纤颤电位。骨化三醇治疗后肌电图结果无明显变化，但所有接受体格检查的患者尿毒症性肌病的临床表现均消失。总之，我们的研究结果表明维生素D缺乏是尿毒症性肌病的原因之一，谨慎使用骨化三醇治疗可减轻尿毒症患者的肌肉无力。
