Intraperitoneal Paricalcitol Treatment for Secondary Hyperparathyroidism in CAPD patient : A Case Report

Korean Journal of Nephrology 2011;30(2):206-210.

Ji Min Jeon, M.D.1, Yong Ki Park, M.D.1, Joon-Suk Oh, M.D.2, Sung-Min Kim, M.D.2, Yong-Hun Sin, M.D.2 and Joong-Kyung Kim, M.D.2

Division of Nephrology¹
Department of Internal Medicine, Dongrae Bong Seng Hospital, Division of Nephrology²
Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea

증례 : 이차성부갑상선기능항진증이 있는 복막투석환자에게 시행한 복강 내 Paricalcitol 투여 치료 1예

전지민1, 박용기1, 오준석2, 김성민2, 신용훈2, 김중경2

Division of Nephrology1, Department of Internal Medicine, Dongrae Bong Seng Hospital, Division of Nephrology2, Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea

Abstract

Secondary hyperparathyroidism is a major complication in ESRD patients undergoing dialysis. In hemodialysis patients with secondary hyperparathyroidism, intravenous administration of paricalcitol became widely utilized. In CAPD patients, however, the intravenous administration of paricalcitol which requires frequent visits to the clinic is not practical. The subject of this study was one CAPD patient with secondary hyperparathyroidism. He had already received oral calcitriol pulse therapy for 6 months and thereafter refused parathyroidectomy and intravenous paricalcitol which required frequent visits to the hospital. Furthermore, paricalcitol capsule is not yet introduced in Korea. Consequently, intraperitoneal paricalcitol therapy was tried whereby the patient was taught how to inject the paricalcitol (5 ug) directly into the dialysate for three times per week before bedtime. Blood samples for measurement of intact parathyroid hormone (iPTH), serum ionized calcium, serum phosphate, serum total alkaline phosphatase levels were obtained at baseline and after 1, 2, 3 and 4 months of treatment. After usage of intraperitoneal paricalcitol for 2 months, there was a significant decrease in iPTH level. In conclusion, intraperitoneal paricalcitol therapy might be effective for suppressing iPTH in CAPD patients with secondary hyperparathyroidism. A large-scale and long-term study must be conducted for safety and clinical effect.

Key Words: Paricalcitol, Intraperitoneal injection, Secondary hyperparathyroidism, CAPD