Comparison Effect of Loading Calcitriolol and Titrating Calcitriol Treatment to Control Hypocalcemia after Parathyroidectomy in Chronic Kidney Disease; Randomized Control Trial

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 234-256-Bone & Calcium Metabolism: Clinical Trials & Case Series
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-252
Sathit - Niramitmahapanya*1, Chaicharn Deerochanawong1, Chadsuphar Sirirachta1, Benjawan Leetrakulpanich Niramitmahapanya2, Udom Krairittichai3 and Pornake Athipan4
1Endocrinology Unit of Rajavithi Hospital, Bangkok, Thailand, 2Nephrology Unit of Rajavithi hospital, Bangkok, Thailand, 3Nephrology Unit of Rajavithi hospital, bangkok, Thailand, 4Otolaryx-head and neck unit of Rajavithi hospital, Bangkok, Thailand
Objective: Compare the effective treatment of calcitriol regimens (loaded and titrated) in the control hypocalcimic hyperparathyroid (HPT) patients who were referred for parathyroidectomy.

Method: Randomized control, open labeled study of twenty-five patients who underwent parathyroidectomy in Rajavithi hospital during August 2009 to September 2010 was performed. We randomized patients in two treatment arms of calcitriol (A; Titrated dose regimen, B; Loaded dose regimen), 25 patients of chronic kidney disease patients that meet criteria. Biochemical factors available within 2 weeks before and after surgery were recorded and analysed.

Result: No significant different in amount of calcium gluconate intravenous use, hypocalcemia and hospital admission durations between titrated and loaded regimen by p=0.1, 0.63 and 0.46 respectively. Loaded regimen ameliorated the mean reduction of day 7 post- operative serum calcium level (0.33±0.99) compared to titrate regimen patients (2.68±2.16, p=0.036).

Conclusion: Loaded calcitriol regimen superior than titrated calcitriol regimen in controlled the first 7 days calcium level of postparathyroidectomy but amount of calcium gluconate intravenous used, hypocalcemia event and duration of hospital stay did not showed any different.

Keywords: Parathyroidectomy, Hyperparathyroidism, Hypocalcemia and Calcitriol

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