Original Research

Paricalcitol Versus Calcitrol in the Treatment of Secondary Hyperparathyroidism in Hemodialysis Dependent Patients

Bilal Javaid1
Faisal Abad Medical University, Faisal Abad
Muhammad Irfan2
King Edward Medical University, Lahore
Irfan Elahi1
Faisal Abad Medical University, Faisal Abad
Sara Akrum1
Faisal Abad Medical University, Faisal Abad
Sumaira Hassan1
Faisal Abad Medical University, Faisal Abad
Ijaz Nabi1
Faisal Abad Medical University, Faisal Abad

✉ Correspondence: Bilal Javaid Email: dr.bilaljavaid160@gmail.com

DOI https://doi.org/10.70302/jpsim.v6i3.2548
Volume: 6, Issue 3 Pages: 259–262 Published: 23 Aug 2025
Received: 18 Sep 2024 Revised: 05 Feb 2025 Accepted: 21 Jul 2025 Published Online: 23 Aug 2025

Abstract

Objective

To compare the efficacy of paricalcitol with calcitriol for treatment of secondary hyperparathyroidism in dialysis patients.

Methods

This Randomized Controlled Trial (RCT) was carried out in Department of Nephrology, FMU & Allied Hospital, Faisalabad in six months period from 13th November 2023 to 12th May 2024. A total of 100 dialysis dependent patients having secondary hyperparathyroidism were included and divided into two groups. Patients in Group A received paricalcitol at a dose of 1µg/day for a period of 12 weeks. Patients in Group B took calcitriol at a dosage of 0.5 micrograms per day for a period of 12 weeks. The effectiveness was evaluated after a treatment period of twelve weeks.

Results

The mean age of patients in group A was 48.48 ± 6.57 years and in group B was 48.0 ± 8.01 years. Out of these 100 patients, 52 (52.0%) were males and 48 (48.0%) were females. Efficacy in Paricalcitol was seen in 41 (82.0%) patients and in Calcitriol was seen in 29 (58.0%) patients with p-value of 0088 which is statistically significant.

Conclusion

This study concluded that paricalcitol is better than calcitriol for treatment of secondary hyperparathyroidism in dialysis patients.

Keywords
Dialysis Secondary Hyperparathyroidism Paricalcitol.

How to Cite This Article

Javaid B, Irfan M, Elahi I, Akrum S, Hassan S, Nabi I. Paricalcitol Versus Calcitrol in the Treatment of Secondary Hyperparathyroidism in Hemodialysis Dependent Patients. J Pak Soc Intern Med. 2025;6(3):259–262. doi:10.70302/jpsim.v6i3.2548

⭳ Download PDF

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. Yang C-W, Harris DC, Luyckx VA, Nangaku M, Hou FF, Garcia GG, et al. Global case studies for chronic kidney disease/end-stage kidney disease care. Kidney Int Suppl. 2020;10(1):e24-e48.
  2. Fernandez-Fernandez B, Sarafidis P, Kanbay M, Navarro-González JF, Soler MJ, Górriz JL, et al. SGLT2 inhibitors for non-diabetic kidney disease: drugs to treat CKD that also improve glycaemia. Oxford University Press; 2020. p. 728-33.
  3. Bozic M, Diaz-Tocados JM, Bermudez-Lopez M, Forné C, Martinez C, Fernandez E, et al. Independent effects of secondary hyperparathyroidism and hyperphosphataemia on chronic kidney disease progression and cardiovascular events: an analysis from the NEFRONA cohort. Nephrol Dialy Transplant. 2022;37(4):663-72.
  4. Zhang Z, Cai L, Wu H, Xu X, Fang W, He X, et al. Paricalcitol versus calcitriol+ cinacalcet for the treatment of secondary hyperparathyroidism in chronic kidney disease in China: a cost-effectiveness analysis. Front Public Health. 2021;9:712027.
  5. Kashif MA. To compare anti-albumin urea effects of valsartan alone with combination of valsartan and amlodipine in patients of chronic kidney disease. Pak J Med Sci. 2016;32(3):613.
  6. Imtiaz S, Alam A. Epidemiology and demography of Chronic Kidney Disease in Pakistan-A review of Pakistani literature. Pak J Kidney Dis. 2023;7(1):2-7.
  7. Zhang T, Ju H, Chen H, Wen W. Comparison of paricalcitol and calcitriol in dialysis patients with secondary hyperparathyroidism: a meta‐analysis of randomized controlled studies. Therap Apher Dialy. 2019;23(1):73-9.
  8. Qaisar MA, ul Abideen Z, Chattah FS, Nadeem M, Qaisar ZHMA, ul Abideen Z, et al. Comparison of Paricalcitol (IV) and Alfacalcidol (IV) in Treatment of Secondary Hyperparathyroidism (SHPT) in Hemodialysis Patients. J Rawalpindi Med Coll. 2020;24(4):378-83.
  9. Liu Y, Liu L-Y, Jia Y, Wu M-Y, Sun Y-Y, Ma F-Z. Efficacy and safety of paricalcitol in patients undergoing hemodialysis: a meta-analysis. Drug Desi Develop Ther. 2019;13:999-1009.
  10. Martín-Carro B, Navarro-González JF, Ortiz A, Zoccali C, Floege J, Ferreira MA, et al. Mineral and bone metabolism markers and mortality in diabetic patients on haemodialysis. Nephrol Dialy Transplant. 2023;38(11):2589-97.
  11. Vazquez MA, Oliver G, Amarasingham R, Sundaram V, Chan K, Ahn C, et al. Pragmatic Trial of Hospitalization Rate in Chronic Kidney Disease. N Engl J Med. 2024;390(13):1196-206.
  12. Eidman KE, Wetmore JB. Managing hyperparathyroidism in hemodialysis: role of etelcalcetide. Int J Nephrol Renovasc Dis. 2018:69-80.
  13. Pérez-Ricart A, Galicia-Basart M, Alcalde-Rodrigo M, Segarra-Medrano A, Sune-Negre J-M, Montoro-Ronsano J-B. Effectiveness of cinacalcet in patients with chronic kidney disease and secondary hyperparathyroidism not receiving dialysis. PLoS One. 2016;11(9):e0161527.
  14. Kubodera N. A new look at the most successful prodrugs for active vitamin D (D hormone): alfacalcidol and doxercalciferol. Molecules. 2009;14(10):3869-80.
  15. Dusilová‐Sulková S. Vitamin D metabolism and vitamin D traditional and nontraditional, target organs: implications for kidney patients. J Renal Care. 2009;35:39-44.
  16. Cardoso MMdA, Machado-Rugolo J, Lima SAM, Andrade LGMd, Curado DdSP, Ponce D. Cost-effectiveness analysis of intravenous paricalcitol vs. oral calcitriol in the treatment of hyperparathyroidism secondary to chronic kidney disease. Braz J Nephrol. 2022;45:95-101.
  17. Hassan AB, Ghalib KW, Jahrami HA, El-Agroudy AE. Prevalence of Musculoskeletal Manifestations in adult kidney transplant’s recipients: a systematic review. Medicina. 2021;57(6):525.
  18. Franchi M, Gunnarsson J, Gonzales-Parra E, Ferreira A, Ström O, Corrao G. Paricalcitol and Extended-Release Calcifediol for Treatment of Secondary Hyperparathyroidism in Non-Dialysis Chronic Kidney Disease: Results From a Network Meta-Analysis. J Clin Endocrinol Metabol. 2023;108(11):e1424-e32.
  19. Teng M, Wolf M, Lowrie E, Ofsthun N, Lazarus JM, Thadhani R. Survival of patients undergoing hemodialysis with paricalcitol or calcitriol therapy. N Engl J Med. 2003;349(5):446-56.
  20. Tentori F, Hunt W, Stidley C, Rohrscheib M, Bedrick E, Meyer K, et al. Mortality risk among hemodialysis patients receiving different vitamin D analogs. Kidney Int. 2006;70(10):1858-65.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2025 Journal of Pakistan Society of Internal Medicine.
📃 In This Issue View All
Review Article Antibiotic Resistance Patterns in Community-Acquired Pneumonia: Emerging Trends Hussain I, Farooq Z Original Article Outcomes of Laparoscopic Cholecystectomy in Acute Cholecystitis: A Retrospective Analysis Raza SH, Butt N, Qureshi AM Original Article Cervical Cancer Screening Awareness Among Rural Women in Punjab Bibi S, Anjum R, Hassan F Original Article Impact of Diabetes Mellitus on Post-Operative Wound Healing in General Surgery Siddiqui FA, Noor M, Akhtar W Review Article Statin Therapy in Non-Alcoholic Fatty Liver Disease: A Systematic Review Nawaz F, Cheema HA, Mehmood Y
👥 More by These Authors
Original Article Prevalence of Hypertension Among Urban Adults in Pakistan: A Cross-Sectional Study Khan TM, Ahmed S, Malik RA Original Article Serum Ferritin as a Prognostic Marker in COVID-19 Severity: A Hospital-Based Study Rehman N, Sheikh I, Javed K Review Article Thyroid Disorders in Pregnancy: Clinical Implications and Management Strategies Baig BI, Usman A Original Article Neonatal Sepsis: Bacteriological Profile and Antibiogram in a Tertiary Care Hospital Iqbal M, Rashid T
🔗 Related Articles By Keywords
Original Article Cervical Cancer Screening Awareness Among Rural Women in Punjab Bibi S, Anjum R, Hassan F Original Article Impact of Diabetes Mellitus on Post-Operative Wound Healing in General Surgery Siddiqui FA, Noor M, Akhtar W Review Article Statin Therapy in Non-Alcoholic Fatty Liver Disease: A Systematic Review Nawaz F, Cheema HA, Mehmood Y Original Article Comparison of Ultrasound-Guided versus Landmark-Based Central Venous Catheter Insertion Zafar S, Gillani SA