Paricalcitol For Secondary Hyperparathyroidism In End-Stage Renal Disease: A Meta Analysis

Objective:To investigate the efficacy and safety of paricalcitol for secondaryhyperparathyroidism in end-stage renal disease.Methods: Randomized controlled trails of paricalcitol in treatment of secondaryhyperparathyroidism in ESRD patients were searched in the database of Pubmed database,Embase database, the Cochrane Central Register of Controlled Trials, Wan Fang, CQVIP,CNKI, the dead line is December2013.Data extracted from the literatures were analyzed withThe Cochrane Collaboration’s Rev Man5.2software.Results:7articles were included finally, which contained564patients. The patients inparicalcitol-treated group achieved≥30%and/or≥50%from baseline was significantlymore than activated vitamin D-treated group[RR=1.15，95％CI (1.02,1.29), P=0.02], and theserum iPTH level was reduced more in paricalcitol-treated group,but the difference was notstatiscally significant. The incidence of hypercalcinemia and elevated Ca×P product inparicalcitol-treated group was lower than activated vitamin D group[RR=0.45，95%CI（0.30，0.66），P<0.0001],[WMD=-0.06，95%CI（-0.09，-0.03），P=0.0003]. The incidence ofhyperphosphatemia,the change of serum calcium level and serum phosphorus level in the twotreated group had no difference（P>0.05）.Conclusion: Paricalcitol may be superior to activated vitamin D in reduce serum iPTHlevel. Paricalcitol can reduce the adverse event rates such as hypercalcinemia,the increasingof Ca×P product.