Suppression of parathormone by calcitriol therapy in hemodialysis patients: A meta-analysis.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:554A 1997
The authors did a meta-analysis to assess the effect of the method of calcitriol administration on PTH suppression. All studies were controlled, of at least 10 weeks duration, and involved adult hemodialysis patients. Four studies compared IV to oral daily (OD), 7 compared IV to oral pulse (OP), and 3 compared OP to OD. The decrease in PTH levels were greater in the IV group (45%) than the OD groups (16%). There was no difference in the IV and OP groups (40 versus 34%). Finally, there was no difference between OP and OD (37 versus 33%). There was also no difference in the incidence of hypercalcemia in the 3 groups. They conclude that IV is superior to OD and IV and OP are equally effective.
Comment: Unless I have forgotten my logic class, the data appear contradictory. Perhaps, because there were only 3 studies comparing OD and OP, there was not enough statistical power. Meta-analysis also has many inherent problems. (James A. Delmez, M.D., Washington University, St. Louis)
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ASN 30th Annual Meeting, San Antonio
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