Document Detail


Antiproteinuric effect of oral paricalcitol in chronic kidney disease.
MedLine Citation:
PMID:  16316359     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Proteinuria is a marker of cardiovascular and renal disease in patients with chronic kidney disease (CKD), and reduction in proteinuria has been associated with improved cardiovascular and renal outcomes. While active vitamin D and its analogs have been shown to have renal protective effects in animals, these hormones have not been shown to reduce proteinuria in CKD patients. METHODS: In three double-blind, randomized, placebo-controlled studies to evaluate the safety and efficacy of oral paricalcitol, 220 CKD stage 3 and 4 patients with secondary hyperparathyroidism (SHPT) were randomized to oral paricalcitol (N= 107, mean dose 9.5 microg/week) or placebo (N= 113) and followed for up to 24 weeks. In conjunction with other safety measures, proteinuria was measured by dipstick and read by an automated reader at the beginning and end of trial. We subsequently analyzed the dipstick data to evaluate the effect of paricalcitol on proteinuria. RESULTS: At baseline, proteinuria was present in 57 patients randomized to oral paricalcitol and 61 patients randomized to placebo (NS). At the final visit, 29/57 (51%) of the paricalcitol patients compared to 15/61 (25%) placebo patients had reduction in proteinuria, P= 0.004 (odds for reduction in proteinuria 3.2 times greater for paricalcitol patients, 95% CI 1.5-6.9). For the patients who had both proteinuria at baseline and parathyroid hormone (PTH) suppression (end point defined as 2 consecutive > or =30% decreases in iPTH from baseline), 27/51 (53%) patients had a reduction in the proteinuria in the paricalcitol group and 0/7 (0%) had a reduction in proteinuria in the placebo group. Reduction of proteinuria favored patients on paricalcitol, regardless of age, sex, race, diabetes mellitus, hypertension, or use of therapies to block the renin-angiotensin-aldosterone system (RAAS). CONCLUSION: Our results demonstrate that the reduction in proteinuria was associated with paricalcitol treatment, and the reduction in proteinuria was independent of concomitant use of agents that block the RAAS. Paricalcitol as a potential pharmacologic means of reducing proteinuria in CKD patients warrants further investigation.
Authors:
Rajiv Agarwal; Muralidhar Acharya; Jin Tian; Richard L Hippensteel; Joel Z Melnick; Ping Qiu; Laura Williams; Daniel Batlle
Related Documents :
3827419 - 'idiopathic' hematuria. a prospective evaluation.
22432969 - Transient elastography and simple blood markers in diagnosis of oesophageal varices for...
8039599 - Clinical and histological correlations of decline in renal function in diabetic patient...
4048389 - Microscopic polyarteritis: presentation, pathology and prognosis.
12966129 - Long-term renal prognosis of diarrhea-associated hemolytic uremic syndrome: a systemati...
3794409 - Bedside urinalysis in untreated leprosy patients.
1440469 - Pulmonary kaposi's sarcoma in africa.
310699 - Size of cerebral ventricles in 66 psychiatric patients.
21725779 - Clinical analysis of electrolyte imbalance in thalamic hemorrhage patients within 24 h ...
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Kidney international     Volume:  68     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-30     Completed Date:  2006-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2823-8     Citation Subset:  IM    
Affiliation:
Indiana University School of Medicine and Richard L. Roudebush VA Medical Center, Indianapolis, IN 46202, USA. ragarwal@iupui.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Ergocalciferols / administration & dosage*
Female
Humans
Hyperparathyroidism, Secondary / drug therapy*,  etiology,  metabolism
Male
Middle Aged
Parathyroid Hormone / metabolism
Proteinuria / complications,  drug therapy*
Renal Insufficiency, Chronic / complications,  drug therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Ergocalciferols; 0/Parathyroid Hormone; 131918-61-1/paricalcitol

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


Previous Document:  Intravenous iron increases labile serum iron but does not impair forearm blood flow reactivity in di...
Next Document:  Beneficial impact of spironolactone in diabetic nephropathy.