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Does 1 alpha(OH)D3 treatment affect blood pressure levels in maintenance hemodialysis patients?

K Shimamatsu1, K Onoyama, S Fujimi

  • 1Kidney Care Unit, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

American Journal of Nephrology
|January 1, 1988
PubMed

Insights

This study found that 1 alpha(OH)D3 treatment in hemodialysis patients increased serum calcium without raising blood pressure, likely due to PTH suppression. Hypocalcemia in these patients also did not affect blood pressure.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiovascular Medicine

Background:

  • Chronic hemodialysis patients often experience hypocalcemia and secondary hyperparathyroidism.
  • Vitamin D analogs are used to manage mineral and bone disorders in these patients.
  • The impact of vitamin D therapy on blood pressure in hemodialysis patients remains a concern.

Purpose of the Study:

  • To investigate the effect of 1 alpha(OH)D3 on serum calcium, parathyroid hormone (PTH), and blood pressure in chronic hemodialysis patients.
  • To determine if induced hypercalcemia affects blood pressure in this population.
  • To explore the relationship between calcium, PTH, and blood pressure regulation.

Main Methods:

  • A randomized, placebo-controlled trial involving 48 chronic hemodialysis patients.
  • One group received 2 micrograms of 1 alpha(OH)D3 for 3 months; the other received a placebo.
  • Serum calcium, intact parathyroid hormone (iPTH), and blood pressure were monitored throughout the study.

Main Results:

  • 1 alpha(OH)D3 significantly increased serum calcium and decreased iPTH levels.
  • No significant changes in systolic, diastolic, or mean blood pressure were observed in the treatment group.
  • Even in patients who developed hypercalcemia, blood pressure remained stable.
  • The placebo group showed no significant changes in measured parameters.

Conclusions:

  • 1 alpha(OH)D3 treatment can safely increase serum calcium in hemodialysis patients without adversely affecting blood pressure.
  • PTH suppression appears to play a role in preventing blood pressure elevation during 1 alpha(OH)D3 therapy.
  • The hypocalcemic state in hemodialysis patients is not associated with significant blood pressure changes.

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