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A randomized trial of cholecalciferol versus doxercalciferol for lowering parathyroid hormone in chronic kidney

Sharon M Moe1, Akber Saifullah, Robert E LaClair

  • 1Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. smoe@iupui.edu

Clinical Journal of the American Society of Nephrology : CJASN
|January 9, 2010
PubMed

Insights

Doxercalciferol showed a within-group reduction in parathyroid hormone (PTH) for chronic kidney disease patients. However, no significant difference was found compared to cholecalciferol, indicating a need for further research.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Secondary hyperparathyroidism is common in chronic kidney disease (CKD).
  • Optimal treatment for secondary hyperparathyroidism in CKD remains unclear.
  • Vitamin D deficiency is prevalent in CKD patients.

Purpose of the Study:

  • To compare the efficacy of doxercalciferol and cholecalciferol in treating secondary hyperparathyroidism in CKD patients.
  • To evaluate the impact of these treatments on parathyroid hormone (PTH) levels.
  • To assess effects on mineral metabolism and other clinical outcomes.

Main Methods:

  • A 3-month randomized, blinded trial was conducted.
  • Participants included vitamin D-deficient CKD stages 3-4 patients with elevated PTH.
  • Cholecalciferol (n=22) was compared to doxercalciferol (n=25).

Main Results:

  • Vitamin D levels significantly increased with cholecalciferol but not doxercalciferol.
  • PTH levels decreased in the doxercalciferol group (P=0.002) but not significantly in the cholecalciferol group (P=0.16).
  • No significant difference in PTH reduction was observed between the two treatment groups (P=0.11).

Conclusions:

  • Doxercalciferol demonstrated a within-group reduction in PTH.
  • No significant difference in efficacy was found between doxercalciferol and cholecalciferol.
  • Larger, long-term studies are required to confirm efficacy and safety for mineral and non-mineral endpoints.
Abstract

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