Calcitriol as Effective as Vitamin D Analogues, but Cheaper

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NATIONAL HARBOR, Md.—Oral calcitriol is as effective as vitamin D analogues for treating secondary hyperparathyroidism (SHPT) in hemodialysis patients but is more cost effective, according to a study presented at the National Kidney Foundation 2012 Spring Clinical Meetings.

Sandeep Aggarwal, MD, and collaborators at Drexel University College of Medicine in Philadelphia retrospectively studied 52 dialysis patients with SHPT who were converted from intravenous vitamin D analogues (paricalcitol or doxercalciferol) to oral calcitriol. The researchers observed no significant differences in calcium and phosphorus levels at three months after switching to calcitriol and at the end of the study at nine months. 

After switching from vitamin D analogues to calcitriol, mean intact parathyroid hormone levels increased from 360 to 418 pmol/L and mean calcium levels rose from 9.19 to 9.50 mg/dL, but the increases were not statistically significant and values remained within guideline targets recommended by the Kidney Disease: Improving Global Outcomes (KDIGO) foundation. The cost per patient per week was $116.40 with vitamin D compared with $6.60 with calcitriol.
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