Endocrine Abstracts

Introduction: Conventional treatment of secondary hyperparathyroidism (SHP) requires supplementation of vitamin d analogues combined with calcium however several studies have reported concerns regarding the safety of calcium supplements particularly in the long term. If vitamin d without concomitant calcium supplementation is sufficient to prompt a fall in the parathyroid hormone (PTH) is still not known with certainty. The purpose of our study was to investigate if vitamin d without calcium effectively suppresses PTH secretion in patients with vitamin d deficiency and a history of gastrointestinal complication in calcium preparations.

Materials and Methods: 29 healthy individuals with SHP due to vitamin d insufficiency were enrolled. Treatment with calcium carbonate and vitamin d suggested to all patients while in those with a history of previous side effects due to calcium intake vitamin d only recommended. Group A (n=16) received 2000 IU vitamin D (Cholecalciferol), and Group B (n=13) received 600 mg calcium carbonate, together with 2000 IU vitamin D, for 60 days. Demographic and laboratory characteristics (serum levels of 25(OH)D, calcium, phosphorous, creatinine, albumin and intact PTH (iPTH) were evaluated at baseline and at the end of the study.

Results: Treatment significantly reduced iPTH and increased 25(OH)D levels in both groups. In vitamin d alone group a significantly increase of phosphorous levels observed. No other significant difference was detected between the two groups.

Conclusion: These preliminary data indicate that 2000IU of daily vitamin d constitute a sufficient alternative and could be preferred particularly when calcium intake may lead to unfavorable side effects or is contradicted.