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    Hypoparathyroidism: Less severe hypocalcemia with treatment with vitamin d2 compared with calcitriol

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    Author
    Streeten, E.A.
    Mohtasebi, Y.
    Konig, M.
    Date
    2017
    Journal
    Journal of Clinical Endocrinology and Metabolism
    Publisher
    Endocrine Society
    Type
    Article
    
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    See at
    https://doi.org/10.1210/jc.2016-3712
    Abstract
    Context: Options for chronic treatment of hypoparathyroidism include calcitriol, recombinant human parathyroid hormone, and high-dose vitamin D (D2). D2 is used in a minority of patients because of fear of prolonged hypercalcemia and renal toxicity. There is a paucity of recent data about D2 use in hypoparathyroidism. Objective: Compare renal function, hypercalcemia, and hypocalcemia in patients with hypoparathyroidism treated chronically with either D2 (D2 group) or calcitriol. Design, Setting, and Patients: A retrospective study of patients with hypoparathyroidism treated at the University of Maryland Hospital. Participants were identified by a billing record search with diagnosis confirmed by chart review. Thirty patients were identified; 16 were treated chronically with D2, 14 with calcitriol. Data were extracted from medical records. Main Outcome Measures: Serum creatinine and calcium, hospitalizations, and emergency department (ED) visits for hypercalcemia and hypocalcemia. Results: D2 and calcitriol groups were similar in age (58.9 ± 16.7 vs 50.9 ± 22.6 years, P = 0.28), sex, and treatment duration (17.8 ± 14.2 vs 8.5 ± 4.4 years, P = 0.076). Hospitalization or ED visits for hypocalcemia occurred in none of the D2 group vs four of 14 in the calcitriol group (P = 0.03); three in the calcitriol group had multiple ED visits. There were no differences between D2 and calcitriol groups in hospitalizations or ED visits for hypercalcemia, serum creatinine or calcium, or kidney stones. Conclusion: We found less morbidity from hypocalcemia in hypoparathyroid patients treated chronically with D2 compared with calcitriol and found no difference in renal function or morbidity from hypercalcemia. Treatment with D2 should be considered in patients with hypoparathyroidism, particularly in those who experience recurrent hypocalcemia. (J Clin Endocrinol Metab 102: 1505-1510, 2017).
    Keyword
    Calcitriol--adverse effects
    Ergocalciferols--adverse effects
    Hypercalcemia--chemically induced
    Hypocalcemia--chemically induced
    Hypoparathyroidism--drug therapy
    Vitamins--adverse effects
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019123610&doi=10.1210%2fjc.2016-3712&partnerID=40&md5=e8d43b5f5b3cc050220538beac966cc4; http://hdl.handle.net/10713/11332
    ae974a485f413a2113503eed53cd6c53
    10.1210/jc.2016-3712
    Scopus Count
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    UMB Open Access Articles 2017

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