Effects of long-term therapy with calcitriol in patients with moderate renal failure

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Abstract
Since abnormalities in divalent ion metabolism occur early in renal insufficiency, treatment of patients with moderate renal failure with calcitriol, a vitamin D metabolite, could halt and/or reverse these disturbances. The effects of long-term treatment with calcitriol (0.5 .mu.g/day) in 3 such patients were evaluated, Serum Ca level rose from 0.3-0.7 mg/dl. Blood parathyroid hormone levels were mildly elevated and fell to normal. Intestinal absorption of Ca increased. The patients had hypocalciuria and the urinary Ca level increased. Creatinine clearance remained stable in all patients. Iliac crest biopsy specimens obtained after double tetracycline hydrochloride labeling revealed mild osteomalacia and hyperparathyroid bone disease that healed after therapy. A small dose of calcitriol is safe and effective for the management of the derangements of divalent ion metabolism in patients with moderate renal failure.