No difference in intestinal strontium absorption after oral or IV calcitriol in children with secondary hyperparathyroidism

G. Ardissino, C. P. Schmitt, M. L. Bianchi, V. Dacco, A. Claris-Appiani, O. Mehls, K. Michelis, P. Sally, D. Drozdz, E. Bonzel, A. Zurowska, F. Perfumo, U. Berg, L. Barletta, F. Campanini, S. Testa, S. Tirelli, M. L. Murer, J. Dusek, M. FishbachS. Picca, M. Wigger, T. Neuhaus

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background. Oral and intravenous calcitriol bolus therapy are both recommended for the treatment of secondary hyperparathyroidism, but it has been claimed that the latter is less likely to induce absorptive hypercalcemia. The present study was undertaken to verify whether intravenous calcitriol actually stimulates intestinal calcium absorption less than oral calcitriol and whether it is superior in suppressing parathyroid hormone (PTH) secretion. Methods. Twenty children (16 males, age range of 5.1 to 16.9 years, mean creatinine clearance 21.9 ± 11.5 mL/min/1.73 m2, range of 7.4 to 52.7) with chronic renal failure (CRF) and secondary hyperparathyroidism [median intact PTH (iPTH), 327 pg/mL; range 143 to 1323] received two single calcitriol boli (1.5 mg/m2 body surface area) orally and intravenously using a randomized crossover design. iPTH and 1,25(OH)2D3 levels were measured over 72 hours, and intestinal calcium absorption was measured 24 hours after the calcitriol bolus using stable strontium (Sr) as a surrogate marker. Baseline control values for Sr absorption were obtained in a separate group of children with CRF of similar severity. Results. The peak serum level of 1,25(OH)2D3 and area under the curve baseline to 72 hours (AUC(0-72h)) were significantly higher after intravenous (IV) calcitriol (AUC(0-72h) oral, 1399 ± 979 pg/mL · hour vs. IV 2793 ± 1102 pg/mL · hour, P <0.01), but the mean intestinal Sr absorption was not different [SrAUC(0-240 min) during the 4 hours after Sr administration 2867 ± 1101 FAD% (fraction of the absorbed dose) vs. 3117 ± 1581 FAD% with oral and IV calcitriol, respectively]. The calcitriol-stimulated Sr absorption was more then 30% higher compared with control values (2165 ± 176 FAD%). A significant decrease in plasma iPTH was noted 12 hours after the administration of the calcitriol bolus, which was maintained for up to 72 hours without any differences regarding the two routes of administration. Conclusions. These results demonstrate that under acute conditions, intravenous and oral calcitriol boli equally stimulate calcium absorption and had a similar efficacy in suppressing PTH secretion.

Original languageEnglish
Pages (from-to)981-988
Number of pages8
JournalKidney International
Volume58
Issue number3
DOIs
Publication statusPublished - 2000

Fingerprint

Strontium
Secondary Hyperparathyroidism
Calcitriol
Intestinal Absorption
Parathyroid Hormone
Area Under Curve
Calcium
Chronic Kidney Failure
Body Surface Area
Hypercalcemia
Cross-Over Studies
Creatinine
Biomarkers

Keywords

  • 1,25(OH)D
  • Calcium absorption
  • Chronic renal failure
  • Hypercalcemia
  • Intact PTH
  • Parathyroid hormone
  • Skeletal deformities in children
  • Vitamin D

ASJC Scopus subject areas

  • Nephrology

Cite this

No difference in intestinal strontium absorption after oral or IV calcitriol in children with secondary hyperparathyroidism. / Ardissino, G.; Schmitt, C. P.; Bianchi, M. L.; Dacco, V.; Claris-Appiani, A.; Mehls, O.; Michelis, K.; Sally, P.; Drozdz, D.; Bonzel, E.; Zurowska, A.; Perfumo, F.; Berg, U.; Barletta, L.; Campanini, F.; Testa, S.; Tirelli, S.; Murer, M. L.; Dusek, J.; Fishbach, M.; Picca, S.; Wigger, M.; Neuhaus, T.

In: Kidney International, Vol. 58, No. 3, 2000, p. 981-988.

Research output: Contribution to journalArticle

Ardissino, G, Schmitt, CP, Bianchi, ML, Dacco, V, Claris-Appiani, A, Mehls, O, Michelis, K, Sally, P, Drozdz, D, Bonzel, E, Zurowska, A, Perfumo, F, Berg, U, Barletta, L, Campanini, F, Testa, S, Tirelli, S, Murer, ML, Dusek, J, Fishbach, M, Picca, S, Wigger, M & Neuhaus, T 2000, 'No difference in intestinal strontium absorption after oral or IV calcitriol in children with secondary hyperparathyroidism', Kidney International, vol. 58, no. 3, pp. 981-988. https://doi.org/10.1046/j.1523-1755.2000.00255.x
Ardissino, G. ; Schmitt, C. P. ; Bianchi, M. L. ; Dacco, V. ; Claris-Appiani, A. ; Mehls, O. ; Michelis, K. ; Sally, P. ; Drozdz, D. ; Bonzel, E. ; Zurowska, A. ; Perfumo, F. ; Berg, U. ; Barletta, L. ; Campanini, F. ; Testa, S. ; Tirelli, S. ; Murer, M. L. ; Dusek, J. ; Fishbach, M. ; Picca, S. ; Wigger, M. ; Neuhaus, T. / No difference in intestinal strontium absorption after oral or IV calcitriol in children with secondary hyperparathyroidism. In: Kidney International. 2000 ; Vol. 58, No. 3. pp. 981-988.
@article{c3befa347ff142dbbda6a3b363d40298,
title = "No difference in intestinal strontium absorption after oral or IV calcitriol in children with secondary hyperparathyroidism",
abstract = "Background. Oral and intravenous calcitriol bolus therapy are both recommended for the treatment of secondary hyperparathyroidism, but it has been claimed that the latter is less likely to induce absorptive hypercalcemia. The present study was undertaken to verify whether intravenous calcitriol actually stimulates intestinal calcium absorption less than oral calcitriol and whether it is superior in suppressing parathyroid hormone (PTH) secretion. Methods. Twenty children (16 males, age range of 5.1 to 16.9 years, mean creatinine clearance 21.9 ± 11.5 mL/min/1.73 m2, range of 7.4 to 52.7) with chronic renal failure (CRF) and secondary hyperparathyroidism [median intact PTH (iPTH), 327 pg/mL; range 143 to 1323] received two single calcitriol boli (1.5 mg/m2 body surface area) orally and intravenously using a randomized crossover design. iPTH and 1,25(OH)2D3 levels were measured over 72 hours, and intestinal calcium absorption was measured 24 hours after the calcitriol bolus using stable strontium (Sr) as a surrogate marker. Baseline control values for Sr absorption were obtained in a separate group of children with CRF of similar severity. Results. The peak serum level of 1,25(OH)2D3 and area under the curve baseline to 72 hours (AUC(0-72h)) were significantly higher after intravenous (IV) calcitriol (AUC(0-72h) oral, 1399 ± 979 pg/mL · hour vs. IV 2793 ± 1102 pg/mL · hour, P <0.01), but the mean intestinal Sr absorption was not different [SrAUC(0-240 min) during the 4 hours after Sr administration 2867 ± 1101 FAD{\%} (fraction of the absorbed dose) vs. 3117 ± 1581 FAD{\%} with oral and IV calcitriol, respectively]. The calcitriol-stimulated Sr absorption was more then 30{\%} higher compared with control values (2165 ± 176 FAD{\%}). A significant decrease in plasma iPTH was noted 12 hours after the administration of the calcitriol bolus, which was maintained for up to 72 hours without any differences regarding the two routes of administration. Conclusions. These results demonstrate that under acute conditions, intravenous and oral calcitriol boli equally stimulate calcium absorption and had a similar efficacy in suppressing PTH secretion.",
keywords = "1,25(OH)D, Calcium absorption, Chronic renal failure, Hypercalcemia, Intact PTH, Parathyroid hormone, Skeletal deformities in children, Vitamin D",
author = "G. Ardissino and Schmitt, {C. P.} and Bianchi, {M. L.} and V. Dacco and A. Claris-Appiani and O. Mehls and K. Michelis and P. Sally and D. Drozdz and E. Bonzel and A. Zurowska and F. Perfumo and U. Berg and L. Barletta and F. Campanini and S. Testa and S. Tirelli and Murer, {M. L.} and J. Dusek and M. Fishbach and S. Picca and M. Wigger and T. Neuhaus",
year = "2000",
doi = "10.1046/j.1523-1755.2000.00255.x",
language = "English",
volume = "58",
pages = "981--988",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "3",

}

TY - JOUR

T1 - No difference in intestinal strontium absorption after oral or IV calcitriol in children with secondary hyperparathyroidism

AU - Ardissino, G.

AU - Schmitt, C. P.

AU - Bianchi, M. L.

AU - Dacco, V.

AU - Claris-Appiani, A.

AU - Mehls, O.

AU - Michelis, K.

AU - Sally, P.

AU - Drozdz, D.

AU - Bonzel, E.

AU - Zurowska, A.

AU - Perfumo, F.

AU - Berg, U.

AU - Barletta, L.

AU - Campanini, F.

AU - Testa, S.

AU - Tirelli, S.

AU - Murer, M. L.

AU - Dusek, J.

AU - Fishbach, M.

AU - Picca, S.

AU - Wigger, M.

AU - Neuhaus, T.

PY - 2000

Y1 - 2000

N2 - Background. Oral and intravenous calcitriol bolus therapy are both recommended for the treatment of secondary hyperparathyroidism, but it has been claimed that the latter is less likely to induce absorptive hypercalcemia. The present study was undertaken to verify whether intravenous calcitriol actually stimulates intestinal calcium absorption less than oral calcitriol and whether it is superior in suppressing parathyroid hormone (PTH) secretion. Methods. Twenty children (16 males, age range of 5.1 to 16.9 years, mean creatinine clearance 21.9 ± 11.5 mL/min/1.73 m2, range of 7.4 to 52.7) with chronic renal failure (CRF) and secondary hyperparathyroidism [median intact PTH (iPTH), 327 pg/mL; range 143 to 1323] received two single calcitriol boli (1.5 mg/m2 body surface area) orally and intravenously using a randomized crossover design. iPTH and 1,25(OH)2D3 levels were measured over 72 hours, and intestinal calcium absorption was measured 24 hours after the calcitriol bolus using stable strontium (Sr) as a surrogate marker. Baseline control values for Sr absorption were obtained in a separate group of children with CRF of similar severity. Results. The peak serum level of 1,25(OH)2D3 and area under the curve baseline to 72 hours (AUC(0-72h)) were significantly higher after intravenous (IV) calcitriol (AUC(0-72h) oral, 1399 ± 979 pg/mL · hour vs. IV 2793 ± 1102 pg/mL · hour, P <0.01), but the mean intestinal Sr absorption was not different [SrAUC(0-240 min) during the 4 hours after Sr administration 2867 ± 1101 FAD% (fraction of the absorbed dose) vs. 3117 ± 1581 FAD% with oral and IV calcitriol, respectively]. The calcitriol-stimulated Sr absorption was more then 30% higher compared with control values (2165 ± 176 FAD%). A significant decrease in plasma iPTH was noted 12 hours after the administration of the calcitriol bolus, which was maintained for up to 72 hours without any differences regarding the two routes of administration. Conclusions. These results demonstrate that under acute conditions, intravenous and oral calcitriol boli equally stimulate calcium absorption and had a similar efficacy in suppressing PTH secretion.

AB - Background. Oral and intravenous calcitriol bolus therapy are both recommended for the treatment of secondary hyperparathyroidism, but it has been claimed that the latter is less likely to induce absorptive hypercalcemia. The present study was undertaken to verify whether intravenous calcitriol actually stimulates intestinal calcium absorption less than oral calcitriol and whether it is superior in suppressing parathyroid hormone (PTH) secretion. Methods. Twenty children (16 males, age range of 5.1 to 16.9 years, mean creatinine clearance 21.9 ± 11.5 mL/min/1.73 m2, range of 7.4 to 52.7) with chronic renal failure (CRF) and secondary hyperparathyroidism [median intact PTH (iPTH), 327 pg/mL; range 143 to 1323] received two single calcitriol boli (1.5 mg/m2 body surface area) orally and intravenously using a randomized crossover design. iPTH and 1,25(OH)2D3 levels were measured over 72 hours, and intestinal calcium absorption was measured 24 hours after the calcitriol bolus using stable strontium (Sr) as a surrogate marker. Baseline control values for Sr absorption were obtained in a separate group of children with CRF of similar severity. Results. The peak serum level of 1,25(OH)2D3 and area under the curve baseline to 72 hours (AUC(0-72h)) were significantly higher after intravenous (IV) calcitriol (AUC(0-72h) oral, 1399 ± 979 pg/mL · hour vs. IV 2793 ± 1102 pg/mL · hour, P <0.01), but the mean intestinal Sr absorption was not different [SrAUC(0-240 min) during the 4 hours after Sr administration 2867 ± 1101 FAD% (fraction of the absorbed dose) vs. 3117 ± 1581 FAD% with oral and IV calcitriol, respectively]. The calcitriol-stimulated Sr absorption was more then 30% higher compared with control values (2165 ± 176 FAD%). A significant decrease in plasma iPTH was noted 12 hours after the administration of the calcitriol bolus, which was maintained for up to 72 hours without any differences regarding the two routes of administration. Conclusions. These results demonstrate that under acute conditions, intravenous and oral calcitriol boli equally stimulate calcium absorption and had a similar efficacy in suppressing PTH secretion.

KW - 1,25(OH)D

KW - Calcium absorption

KW - Chronic renal failure

KW - Hypercalcemia

KW - Intact PTH

KW - Parathyroid hormone

KW - Skeletal deformities in children

KW - Vitamin D

UR - http://www.scopus.com/inward/record.url?scp=0033864586&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033864586&partnerID=8YFLogxK

U2 - 10.1046/j.1523-1755.2000.00255.x

DO - 10.1046/j.1523-1755.2000.00255.x

M3 - Article

C2 - 10972662

AN - SCOPUS:0033864586

VL - 58

SP - 981

EP - 988

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 3

ER -