Research to cost-effectiveness of paricalcitol of the treatment of secundary hyperparathyroidism at hemodialysis patients

The inadequate treatment of secondary hyperparathyroidism can have severe consequences, for example hyperplastic parathyroid glands, renal osteodystrophy and cardiovascular dis-eases.

Paricalcitol (Zemplar®) is a recently introduced third generation vitamin D analogon. The treatment with paricalcitol could have several advantages to the treatment with the “old” vi-tamin D analogon: alfacalcidol (Etalpha®).

Paricalcitol should correct the parathormone (PTH) level faster and reduce the numbers of hypercalcemia episodes. The trial is limited and the database on this subject is small, so the question if paricalcitol is more effective than the “old” vitamin D analoga alfacalcidol and calcitriol is relevant. This trial compares paricalcitol with alfacalcidol, the most used vitamin D in the Netherlands. The treatment with paricalcitol is four times more expensive that the treatment with alfacalcidol. The trial that compares the effectiveness, security and the costs between paricalcitol and alfacalcidol will give a useful insight to optimize the treatment for hemodialysispatients with secondary hyperparathyroidism

Paricalcitol induce a more effective reduction of the PTH level compared to alfacalcidol at hemodialysispatients with secondary hyperparathyroidism

PTH: Every 4 weeks inclusive the Baseline

Ca 2+ tot: Every 2 weeks inclusive the Baseline

Ca2+ ion: Every 2 weeks inclusive the Baseline

Alb serum: Every 2 weeks inclusive the Baseline

P: Every 2 weeks inclusive the Baseline

Ca2+ x P: Every 2 weeks inclusive the Baseline


Bone-AP: Baseline, month 6, month 12

Hb: Every 4 weeks

Ferritine: Every 4 weeks

Urea (BUN): Baseline, month 6, month 12

Creat: Baseline, month 6, month 12

CRP: Baseline, month 6, month 12

After randomisation two groups of hemodialysispatients will be separated.
Group A gets treated with alfacalcitol and Group B with paricalcitol.
After six months will the groups switch.