of hemodialysis patients with calcitriol. This drug should be started when the PTH>200 pg/ml.
However, the appropriate level of serum alkaline phosphates (ALP) for starting calcitriol is
unclear. The aim of this study was to determine serum ALP as cutoff point for treatment of
secondary hyperparathyroidism with calcitriol.
Method and Material: This study was a cross sectional. The serum level of PTH and ALP were
measured in 75 chronic hemodialysis patients.
Results: The correlation between PTH and ALP in diagnosis for treatment with calcitriol was
significant (Kappa test P-Value=0.000). In determination of diagnostic value of ALP (at level
300IU/L) for treatment with calcitriol, sensitivity, specificity, positive predictive value, negative
predictive value and accuracy were 88.9%, 93.9%, 66.7%, 98.4% and 93.3%, respectively. The
cutoff point of ALP for treatment with calcitriol was 300 IU/L (normal 100-290 IU/L).
Conclusion: These findings suggest that serum ALP is a good test for treatment of secondary
hyperparathyroidism. The results also indicate that calcitriol administration should not be started
with ALP<300 IU/L.
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