Abstract: Objective To observe the efficiency and safety of calcitonin (elcitonin) in the treatment of chronic kidney disease-mineral and bone disorder. Methods A total of 30 patients with bone and joint pain, hypercalcemia, skin itch, and skin metastatic calcification nodules were enrolled in this study. All of them were on maintenance hemodialysis for more than 2 years. Elcitonin 20U was intramuscularly or subcutaneously injected once per day for one week and then 3 times per week after dialysis for a therapeutic course of 12 weeks. They also had low salt and low purine diet. Active vitamin D3 and calcium supplement were withdrawn
in patients with hypercalcemia. Blood routine examination (hemoglobin, white blood cells and platelets), liver functions (direct and indirect bilirubin, alanine aminotransferase and aspartate aminotransferase), serum calcium, serum phosphate, intact parathyroid hormone (iPTH), and bone mineral density of the 3rd and 4th lumbar vertebrae were examined. Visual analogue score (VAS) was used to record the pain. Adverse reaction of elcitonin was monitored. Results After the treatment, serum calcium decreased overtime, and decreased significantly after the treatment for 8 weeks as compared with the baseline (t=2.424, P= 0.019). Serum phosphate and VAS also decrease overtime, and decreased significantly after the treatment for 12 weeks as compared with the baseline (t= 2.061, P=0.044 for phosphate; χ2=51.463, P＜0.0001 for VAS). However, iPTH decrease after the treatment but without statistical significance (χ2=11.120, P=0.069). Bone mineral density was observed in 3 cases, and the density increased after the treatment. Conclusion Elcitonin can decrease serum calcium and phosphate, increase bone mineral density, and alleviate joint pain. Elcitonin can be used in the treatment of renal osteodystrophy.

Key words: Hemodialysis, Chronic Kidney Disease-Mineral and Bone Disorder