Stage 3 or 4 Chronic Kidney Disease
- PO (Adults ): Baseline intact PTH (iPTH) concentration ≤500 pg/mL: Initiate with 1 mcg/day or 2 mcg 3 times weekly; adjust dose at 2–4 wk intervals based on iPTH, calcium, and phosphate concentrations; Baseline iPTH concentration >500 pg/mL: Initiate with 2 mcg/day or 4 mcg 3 times weekly; dose can be adjusted at 2–4 wk intervals based on iPTH, calcium, and phosphate concentrations.
- PO (Children ≥10 yr): 1 mcg 3 times weekly; adjust each dose in 1–mcg increments every 4 wk based on iPTH, calcium, and phosphate concentrations.
Stage 5 Chronic Kidney Disease
- PO (Adults ): Initial dose (in mcg) is based on following equation: baseline iPTH concentration (pg/mL)/80; dose should be given 3 times weekly; adjust dose at 2–4 wk intervals based on iPTH, calcium, and phosphate concentrations.
- PO (Children ≥10 yr): Initial dose (in mcg) is based on following equation: baseline iPTH concentration (pg/mL)/120; dose should be given 3 times weekly; adjust each dose in 1–mcg increments every 4 wk based on iPTH, calcium, and phosphate concentrations.
- IV (Adults and Children ≥5 yr): 0.04–0.1 mcg/kg 3 times weekly during dialysis; dose can be adjusted by 2–4 mcg at 2–4 wk intervals based on iPTH, calcium, and phosphate concentrations (doses up to 0.24 mcg/kg have been used).
