High doses of oral calcitriol pulse therapy reduce parathyroid gland mass

A 22-year-old man on CAPD for six months with severe hyperparathyroidism (intact PTH 1021 pg/ml, alkaline phosphatase 1421 UI/L) was treated with high dose (0.086 (mu)/kg) oral calcitriol pulse therapy inducing a progressive reduction of PTH and alkaline phosphatase and a total ultrasonographic regression of parathyroid hyperplasia of two glands and partial regression of the other two. The high dose oral calcitriol pulse therapy in the early period of chronic dialysis, appeared to function as 'pharmacological' subtotal parathyroidectomy before surgical removal.