Intern Doctor, An-Najah National University
To find out whether the way of administering the oral drug can affect the outcome of the patients.
The research is a clinical trial based one. It focuses on the effect of the intermittent administration of oral Vitamin D analogue, alfacalcidiol, for the renal failure patients can have better outcomes compared with the traditionally used method of administering it daily in a continuous fashion. Vitamin D is used for the treatment of one of the main complications of renal failure, hyperparathyroidism, which is an elevation of the parathyroid hormone in the blood as a compensatory mechanism of the body to regulate the serum electrolyte levels namely calcium. But the problem with the hyperparathyroidism is the negative effects on the bones by causing another problem called renal osteodystrophy. SO that, alfacalcidiol, vitamin D analogue, is used orally to suppress the elevation of the parathyroid hormone and prevents its complications. Our research was performed at An-Najah National University Teaching hospital between the periods October 2016- January 2017. 184 renal failure patients were enrolled in the study and about 167 completed with us. The patients were randomly allocated into two groups, pulse (intermittent) and the continuous (daily) groups. The pulse group received their dose of alfacalcidiol drug in an intermittent fashion, 3 times weekly, at each dialysis session and the daily group continued there drug as usual. Both groups were symmetrical to each other in terms of gender, age, duration of dialysis, diabetic status and baseline electrolyte and parathyroid hormone levels. The pulse group received their dose of drug by calculating their daily doses multiplied by 7 ( 7 days/week) and dividing the result by 3 (3 dialysis sessions). By the end of the study, we found that the reduction of parathyroid hormone level among the pulse group was statistically significant and much more than the daily group, but when comparing both groups and despite the greater reduction in the pulse group, it was not statistically different .
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