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1,25 dihydroxycholecalciferol effects in chronic dialysis. A double-blind controlled study
Annals of Internal Medicine
|June 1, 1978
Summary
1,25 dihydroxycholecalciferol (1,25(OH)2D3) effectively treats renal osteodystrophy in dialysis patients by increasing serum calcium and improving bone histology. Careful monitoring is needed to prevent hypercalcemia.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Chronic kidney disease often leads to secondary hyperparathyroidism and renal osteodystrophy.
- Vitamin D3 supplementation may not adequately address these complications in patients on chronic dialysis.
Purpose of the Study:
- To evaluate the efficacy and safety of 1,25 dihydroxycholecalciferol (1,25(OH)2D3) compared to vitamin D3 in managing renal osteodystrophy.
- To assess the impact on serum calcium, parathyroid hormone levels, and bone histology.
Main Methods:
- A double-blind, controlled study comparing 1,25(OH)2D3 with vitamin D3 in patients undergoing chronic dialysis.
- Measurements included serum calcium, immunoreactive parathyroid hormone, and iliac-crest bone biopsies.
Main Results:
- 1,25(OH)2D3 significantly increased serum calcium and decreased parathyroid hormone levels.
- Bone biopsies showed histologic improvement in patients treated with 1,25(OH)2D3, unlike those on vitamin D3.
- Hypercalcemia occurred in a subset of patients receiving 1,25(OH)2D3.
Conclusions:
- 1,25(OH)2D3 demonstrates a calcemic effect and improves bone disease in dialysis patients.
- It is a valuable treatment for renal osteodystrophy but requires vigilant serum calcium monitoring to avoid hypercalcemia.
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