Clinical efficacy of paricalcitol combined with lanthanum carbonate in treatment of mineral and bone metabolism disorder in patients with chronic kidney disease undergoing maintenance hemodialysis
Hu Meng-tian
Yan Wen-jing
Abstract：Objective To investigate the clinical efficacy of paricalcitol combined with lanthanum carbonate in the treatment of mineral and bone metabolism disorder in patients with chronic kidney disease receiving maintenance hemodialysis. Methods A retrospective analysis was conducted on 125 patients with chronic kidney disease complicated with mineral and bone metabolism disorder undergoing maintenance hemodialysis in Suzhou Ninth People's Hospital from June 2022 to March 2024. According to different treatment plans,they were divided into the calcitriol group of 61 cases (bone Cheatriol capsules combined with lanthanum carbonate chewable tablets),and the paricalcitol group of 64 (paricalcitol injection combined with lanthanum carbonate chewable tablets). The levels of blood phosphorus,blood calcium,serum intact parathyroid hormone (iPTH) levels,high-sensitivity C-reac-tive protein (hs-CRP),alkaline phosphatase (ALP),25-Hydroxyvitamin D (25(OH)D) and occurrence of adverse reactions were compared between the two groups. Results After treatment,the overall achievement rate,serum phosphorus,serum calcium,and iPTH achievement rates in the paricalcitol group were 87.50％ (56/64),90.63％ (58/64),87.50％ (56/64),and 92.19％ (59/64),respectively,all of which were higher than those of the calcitriol group at 70.49％ (43/61),73.77％ (45/61),70.49％ (43/61),and 70.49％ (43/61),respectively (x2=5.484,6.118,5.484,9.791,all P<0.05). Both groups showed improvements in serological in-dicators after treatment. The paricalcitol group had higher blood calcium levels ((2.46±0.32) mmol·L-1) than the calcitriol group ((2.31±0.29) mmol·L-1),and lower blood phosphorus and iPTH levels ((1.54±0.16) mmol·L-1,(237.81±28.62) pg·mL-1) as com-pared with the calcitriol group ((1.68±0.19) mmol·L-1,(285.64±31.66) pg·mL-1) (t=2.742,4.464,8.868,all P<0.05). Both groups also showed improvements in bone metabolism indicator and inflammatory factor levels after treatment as compared with those before treatment. The paricalcitol group had higher 25(OH)D levels ((32.98±4.53) ng·mL-1) than the calcitriol group ((28.96±4.18) ng·mL-1),and lower ALP and hs-CRP levels ((63.77±5.21) U·L-1,(10.06±1.32) mg·L-1) as compared with those in the calcitriol group ((71.24±6.89) U·L-1,(14.51±1.49) mg·L-1) (t=5.149,6.858,17.694,all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Paricalcitol combined with lanthanum carbon-ate has better clinical efficacy than calcitriol combined with lanthanum carbonate in the treatment of mineral and bone metabolism disorder in patients with chronic kidney disease undergoing maintenance hemodialysis and can effectively regulate blood calcium,blood phosphorus,iPTH and levels of inflammatory factors,improve bone metabolism,and has good safety.
Keywords：CalcitriolParicalcitolLanthanum carbonateHemodialysisChronic kidney diseaseMineral and bone metabolism disorder
Publication Date：2024-12-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 713-716 )