A proposed paricalcitol-based treatment protocol for secondary hyperparathyroidism (SHPT) that includes limited use of calcium-based phosphate binders may reduce the risk hypercalcemia in non-dialysis chronic kidney disease (CKD) patients, according to the findings of a prospective cohort study presented at the European Renal Association-European Dialysis and Transplant Association 53rd Congress in Vienna.
Pablo Molina, MD, of the Valencian Society of Nephrology and Dr Peset University Hospital in Valencia, Spain, and colleagues compared a treatment cohort of 249 stage 3 and 4 CKD patients who received the proposed protocol and a control cohort of 498 CKD patients who had no restriction on the use of calcium-based binders and vitamin D metabolites. The treatment and control arms were matched for age, gender, comorbidities, and CKD stages.
A significantly higher proportion of patients receiving the proposed regimen achieved target calcium levels compared with the control arm at 6 months (65% vs. 55%) and 12 months (64% vs. 55%). At the end of the study, the rate of hypercalcemia was significantly higher in the control arm than the study group (12% vs. 4%). Both groups had similar mean parathyroid hormone, calcium, and phosphorus levels.