The influence of 1 alpha-hydroxycholecalciferol on left ventricular function in end-stage renal failure

This study was designed to assess the influence of 1 alpha-hydroxycholecalciferol on left ventricular function in end-stage renal failure. Twelve patients, all of whom were on regular haemodialysis, were investigated. M-mode echocardiography and systolic time intervals were used to derive indices of left ventricular function. Measurements were performed before and six weeks after treatment with one microgram daily of 1 alpha-hydroxycholecalciferol. Fractional fibre shortening increased from 34.6 to 37.6% (p less than 0.025) and mean velocity of fibre shortening increased from 1.21 to 1.32 circ/sec (p less than 0.01). These changes were associated with a fall in the mean plasma parathyroid hormone concentration from 1883 to 1123ng/L (p less than 0.0025) and a rise in magnesium concentration from 0.89 to 1.06 mmol/L (p less than 0.0025); plasma calcium increased from 2.59 to 2.70mmol/L but this change was not significant. Our results indicate that 1 alpha-hydroxycholecalciferol improves left ventricular function in end-stage renal failure by influencing both the turnover or secretion of parathyroid hormone and the metabolism of calcium and magnesium ions.