Doxercalciferol Versus Calcitriol for Treatment of Secondary Hyperparathyroidism in Patients of Chronic Kidney Disease-Efficacy and Safety

Secondary hyperparathyroidism is most common complication arising in chronic kidney disease as a part of mineral bone disorder. Doxercalciferol effectively suppresses parathyroid hormone level without having side effects like hypercalcemia and hyperphosphatemia, which are much common with earlier vitamin D analogues. It was an open, prospective study of three months duration conducted on fifty adult patients of chronic kidney disease stage III or IV already on regular follow up of kidney and dialysis clinic at Pt. B.D. Sharma PGIMS, Rohtak. Patients were randomly assigned to one of the two groups, Group I (n = 25) patients received calcitriol in dosage of 0.5 g day-1 and Group II (n = 25) received doxercalciferol in dosage of 1 g day-1. Patients were followed and renal investigations were carried out on monthly basis, iPTH levels were measured in the beginning and at the end of the study. The mean iPTH level decreased by 13.44% in group I and 43.1% in group II after 12 weeks of treatment (p<0.05). There were less episodes of hypercalcemia with doxercalciferol (3 patients) as compared to calcitriol (8 patients). No statistically significant difference was observed in serum phosphorous, serum calcium phosphate product and GFR in both the groups. Doxercalciferol is more effective than calcitriol in controlling secondary hyperparathyroidism in patients of CKD without any adverse effects like hypercalcemia.