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Effect of alfacalcidol on cardiac function in patients with chronic kidney disease stage 4 and secondary

Per Ivarsen1, Johan Vestergaard Povlsen, Kent Lodberg Christensen

  • 1Departments of Nephrology, Aarhus University Hospital, Aarhus, Denmark. pi@dadlnet.dk

Scandinavian Journal of Urology and Nephrology
|June 26, 2012
PubMed

Insights

Short-term alfacalcidol treatment in chronic kidney disease (CKD) patients did not reduce left ventricular hypertrophy (LVH). However, it improved left ventricular function, potentially leading to long-term issues.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Left ventricular hypertrophy (LVH) is common in chronic kidney disease (CKD) and predicts cardiovascular mortality.
  • Vitamin D deficiency may contribute to LVH and dysfunction in CKD patients.

Purpose of the Study:

  • To investigate the effect of alfacalcidol on LVH and left ventricular function in CKD patients.
  • To assess if alfacalcidol can reverse LVH in CKD with secondary hyperparathyroidism.

Main Methods:

  • An open-label, randomized study comparing alfacalcidol to no treatment.
  • 14 CKD patients with LVH were randomized; 6 received alfacalcidol, 7 did not.
  • Echocardiography assessed left ventricular mass and function over 6 months.

Main Results:

  • Alfacalcidol significantly decreased parathyroid hormone and increased serum calcium.
  • Left ventricular mass index remained unchanged.
  • Fractional shortening and Tei index improved, indicating hyperdynamic but less effective function.

Conclusions:

  • Short-term alfacalcidol did not regress LVH in CKD patients.
  • Left ventricular function became hyperdynamic but less effective, posing potential long-term risks.
Abstract

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