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| Study on Effect of Calcitriol Combined with Cinacacet in the Treatment of Secondary Hyperparathyroidism in Hemodialysis Patients |
| FEI Pei, ZHANG Qinghong, CHENG Peng |
| Taihe Hospital Affiliated to Hubei Medical College,Hubei Shiyan 442000,China |
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Abstract Objective: To investigate the clinical effect and safety of application of calcitriol combined with cinacalcet in the treatment of secondary hyperparathyroidism in hemodialysis patients.Methods: The patients who were treated in our hospital between June 2016 and June 2019 were included.A total of 90 patients were included.They were divided into a random control group and a treatment group with 45 patients in each group.For patients in the control group,the main treatment was oral cinacalcet hydrochloride tablets.The starting dose was 25 mg/d,and the maximum dose was controlled at 75 mg/d.For patients in the treatment group,on the basis of receiving the treatment of the patients in the control group,oral calcitriol capsules were taken at the same time.The starting dose was 3 times a week,and then the dose was adjusted according to the patient's situation.Both groups of patients were treated for 3 months.The effects of the two groups of patients were analyzed,and the changes of blood calcium,blood phosphorus levels,parathyroid hormone,alkaline phosphatase,and parathyroid volume in the two groups of patients before and after treatment were compared.Results: The effective rate of the treatment group was 93.33%,and the effective rate of the control group was 77.77%.The effective rate of the treatment group was significantly higher than that of the control group (χ2=4.406,P=0.041).The blood calcium and blood phosphorus levels of the patients before and after treatment were compared,and there was no significant difference before treatment (P>0.05).After treatment,the blood phosphorus level of the treatment group changed more than the control group (P<0.05),while the blood calcium level of the treatment group changed less than the control group (P<0.05).The total parathyroid hormone and alkaline phosphatase of the two groups of patients were found to be no significant difference before treatment (P>0.05).After treatment,the total parathyroid hormone and alkaline phosphatase of the two groups of patients were reduced,(P<0.05).Compared with the control group,the patients in the treatment group changed more.After treatment,the parathyroid glands of the two groups of patients were significantly improved in length,width,thickness and volume,and the improvement effect in the treatment group was more significant (P<0.05).Conclusion: In the treatment of secondary hyperparathyroidism in hemodialysis patients,calcitriol combined with cinacalcet has a good effect,and it can also significantly reduce the volume of parathyroid glands and further control the occurrence of adverse reactions.
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2020, Vol. 26 
