Document Detail


1,25(OH)2D3 administration in moderate renal failure: a prospective double-blind trial.
MedLine Citation:
PMID:  2651758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study represents the first randomized prospective, double-blind, placebo-controlled trial of the efficacy of 1,25(OH)2D3 on bone histology and serum biochemistry in patients with mild to moderate renal failure. Sixteen patients with chronic renal impairment (creatinine clearance 20 to 59 ml per min) received either 1,25(OH)2D3, at a dose of 0.25 to 0.5 microgram daily (eight patients), or placebo. Transiliac crest bone biopsies were performed before entrance into the study and after 12 months of experimental observation. None of the patients were symptomatic or had radiological evidence of bone disease. Of the thirteen patients who completed the study, initial serum 1,25(OH)2D levels were low in seven patients and parathyroid hormone levels were elevated in seven patients. Bone histology was abnormal in all patients. 1,25(OH)2D3 treatment was associated with a significant fall in serum phosphorus and alkaline phosphatase concentrations as well as with histological evidence of an amelioration of hyperparathyroid changes. In contrast to previous reports, no deterioration of renal function attributable to the treatment occurred, perhaps because a modest dose of 1,25(OH)2D3 was employed combined with meticulous monitoring. Further investigation is required to determine whether alternative therapeutic strategies (smaller doses or intermittent therapy) may avoid the potential for suppressing bone turnover to abnormally low levels in the long term.
Authors:
L R Baker; L Abrams; C J Roe; M C Faugere; P Fanti; Y Subayti; H H Malluche
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international     Volume:  35     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  1989 Feb 
Date Detail:
Created Date:  1989-06-08     Completed Date:  1989-06-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  661-9     Citation Subset:  IM    
Affiliation:
Department of Nephrology, St. Bartholomew's Hospital, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bone Development / drug effects
Calcitriol / therapeutic use*
Clinical Trials as Topic
Double-Blind Method
Female
Humans
Hyperparathyroidism, Secondary / prevention & control
Kidney Failure, Chronic / drug therapy*
Male
Middle Aged
Prospective Studies
Random Allocation
Time Factors
Chemical
Reg. No./Substance:
32222-06-3/Calcitriol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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