24-25-dihydroxyvitamin-d-3 and Osteitis-Fibrosa-Cystica

The available data with regard to the use of calcitriol, 1 alpha-hydroxyvitamin D3 (1 alpha-OH D3), and 24,25-dihydroxyvitamin D3 (24,25-[OH]2D3) in the management of chronic renal insufficiency are reviewed. Patients with mild to moderate osteitis fibrosa experience substantial improvement with either calcitriol or 1 alpha-OH D3 therapy. However, few patients experience a reversal to normal in histologic characteristics of bone. The conditions of patients with osteomalacia do not respond to either calcitriol or 1 alpha-OH D3 therapy. The bone lesion appearing in these patients is most likely a toxic effect of aluminum. The prognosis is usually poor, but the conditions of some patients may respond to administration of 24,25-(OH)2D3 together with calcitriol. Preliminary data suggest that use of chelating agents may be beneficial. In this group of patients, 24,25-(OH)2D3 administration together with calcitriol may be beneficial.

Topics: 24,25-Dihydroxyvitamin D 3; Adult; Alkaline Phosphatase; Animals; Bone and Bones; Calcitriol; Chelating Agents; Child; Densitometry; Dihydroxycholecalciferols; Drug Therapy, Combination; Humans; Hydroxycholecalciferols; Hypercalcemia; Kidney Failure, Chronic; Magnesium; Osteitis Fibrosa Cystica; Osteomalacia; Parathyroid Hormone; Phosphates; Prognosis; Radiography; Rats; Renal Dialysis