Muh. Isnaini Zuhri, S.Farm., Apt, 051415153002 (2017) EFEK PEMBERIAN PARICALCITOL TERHADAP KADAR SERUM KALSIUM, FOSFAT, HORMON PARATIROID INTACT DAN TATRATE-RESISTANT-ACIDPHOSPHATASE TYPE 5B PADA PASIEN PENYAKIT GINJAL KRONIK STADIUM 5 DENGAN HEMODIALISA. Thesis thesis, Universitas Airlangga.

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Abstract

Background: Mineral and bone disorder is a common complication in hemodialysis (HD) patients and leads to substantial increases in fracture rate, morbidity, and mortality. It is associated with secondary hyperparathyroidism. Paricalcitol has been shown to reduce secondary hyperparathyroidsm and its complication with minimal calcemic and phosphatemic activity. Tartrate-resistant acid phsophatase (TRAP) 5b is a new marker of bone resorption that is unaffected by renal dysfunction. However, information about its efficacy on bone resorption is lacking. This study was designed to determine the effect of paricalcitol therapy on calcium, phosphate, intact parathyroid hormone and TRAP-5b in end stage renal disease. Methods : A Prospective cohort study was carried out from September to November in Undaan Wetan Hospital, Surabaya. There were 9 patients of end stage renal disease with mineral and bone disorders, 4 on paricalcitol therapy, received 5 μg of paricalcitol every HD session for three months. Five patients in group without paricalcitol. Levels of calcium, phosphate, iPTH, and TRAP-5b were measured before initiation of study and after three months therapy for both groups. Results: The baseline characteristics between two groups were similiar. Administration of paricalcitol caused no significant change in all parameters. However, in group without paricalcitol group, there was a significant increase level of iPTH (p=0.005) and TRAP-5b (p=0.022). The differences test (pooled t-test) between group showed there were no significant differences between two groups in all tested parameters. Furthermore, a correlation test between iPTH and marker TRAP-5b, showed significant positive correlation (p=0.002, r =0.476). Conclusion: In HD patients, administration of three months paricalcitol maintained levels of iPTH and TRAP-5b without affect calcium and phosphate levels compared without paricalcitol therapy. A higher level of iPTH may correlate with higher level of TRAP5b.

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