Abstract: Objective  To investigate the efficacy of calcitriol at different doses and routes of administration for hemodialysis with severe secondary hyperparathyroidism.Methods  Sixty patients with hemodialysis and severe secondary hyperparathyroidism were randomly divided into the control group (conventional dose of oral calcitriol),  the shock treatment group (large dose of calcitriol) and the intravenous drug group (intravenous administration of calcitriol after dialysis),  serum iPTH,  calcium and phosphorus were detected every 4 weeks,  and adverse reactions were observed.Results  After 12 weeks of treatment,  the level of parathyroid hormone in the conventional dose of calcitriol treatment group was (697.5±164.3)  pg/ml,  which was not significantly different from that before treatment (761.4±184.6  pg/ml,P>0.05).The highdose calcitriol shock treatment was moreeffectivethan theconventional dose of calcitriol,  but some patients had hypercalcemia. The intravenous medication had the best effect on severe secondary hyperparathyroidism(before treatment: 814.7±197.8, after treatment: 227.4±106.4, P<0.01),  and hypercalcemia was rare. Conclusion  At present, calcitriol injection can be prioritized in terms of the treatment of hemodialysis patients with severe secondary hyperparathyroidism. 

Key words: secondary hyperparathyroidism, hemodialysis, calcitriol