Abstract: 【Abstract】Objectives To observe the efficacy of paricalcitol combined with hemoperfusion on secondary hyperparathyroidism (SHPT) in maintenance hemodialysis (MHD) patients. Methods Thirty MHD patients with SHPT were randomly divided into group A (treated with paricalcitol) and group B (treated with paricalcitol plus hemoperfusion). They were followed up for 12 weeks. During the 12 weeks treatment period, biochemical markers were assayed at baseline and every 4 weeks, and serum intact parathyroid hormone (iPTH), calcium, phosphorus and alkaline phosphatase (ALP) were assayed every 2 weeks. The efficacy parameter was set at the decrease of iPTH more than 30% of baseline value after 12 weeks treatment. The incidence of adverse events was also observed. Results ① Compared to the baseline levels, serum iPTH and ALP were significantly declined after the treatment for 4 weeks in both groups (in group A: t=6.048 and 3.459, P＜0.001 and 0.004; in group B: t=6.776 and 3.366, P＜0.001 and 0.005). After the treatment for 8 weeks, paricalcitol dosage, serum iPTH and serum ALP were markedly declined in group B than in group A (t=3.298, 2.635 and 2.508, P=0.003, 0.014 and 0.018). ②After the treatment for 12 weeks, the number of patients with the decrease of iPTH more than 30% of the baseline value were 10 in group A and 12 in group B. ③Compared with the baseline values, serum phosphorus and calcium-phosphorus product were markedly declined after the treatment for 4 weeks in group B (t=19.176 and 4.801, P＜0.001), and serum calcium was higher after the treatment for 2 weeks in both groups (group A: t=2.926, P=0.011; group B: t=2.756, P=0.015). After the treatment for 4 weeks, serum phosphorus and calcium-phosphorus product were apparently lower in group B than in group A (t=3.889 and 3.510, P=0.001 and 0.002). Conclusions Paricalcitol therapy is effective for lowering serum iPTH in MHD patients with SHPT; paricalcitol combined with hemoperfusion will have better effects in lowering paricalcitol dosage, serum phosphorus and calcium-phosphorus product.

Key words: Paricalcitol, Hemoperfusion, Secondary hyperparathyroidism