DETERIORATION OF RENAL BONE DISEASE IN PATIENTS TREATED WITH SALMON CALCITONIN

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Abstract
Twelve patients with chronic renal failure and osteitis fibrosa were treated for periods of 1-9 mo. with thrice-weekly injections of 10-200 IU salmon calcitonin. Treatment had no significant effects on symptoms of bone disease and side effects were common. A transient fall in plasma alkaline phosphatase levels occurred in only 3 patients, and both plasma alkaline phosphatase and hydroxyproline levels rose in the majority of patients. Radiographic signs of hyperparathyroidism increased in 7 of the 9 patients treated for > 3 mo. Paired bone biopsy specimens in 9 patients showed significant increases in osteoblast counts, but no changes in the indices of resorption. These treatment induced changes were reversed when treatment with 1,25-dihydroxyvitamin D3 was substituted for calcitonin. The use of this regimen of salmon calcitonin is not recommended in the long-term management of hyperparathyroid bone disease in chronic renal failure.