In:
Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 2 ( 2008-08), p. 249-255
Abstract:
Vitamin D receptor activation is associated with improved survival in patients with chronic kidney disease, but the mechanism of this benefit is unclear. To better understand the effects of vitamin D on endothelial function, blood pressure, albuminuria, and inflammation in patients with chronic kidney disease (2 patients stage 2, remaining stage 3), we conducted a pilot trial in 24 patients who were randomly allocated equally to 3 groups to receive 0, 1, or 2 μg of paricalcitol, a vitamin D analog, orally for 1 month. Placebo-corrected change in flow mediated dilatation with a 1-μg dose was 0.5% and 0.4% with a 2-μg dose ( P 〉 0.2). At 1 month, the treatment:baseline ratio of high sensitivity C-reactive protein was 1.5 (95% CI: 1.1 to 2.1; P =0.02) with placebo, 0.8 (95% CI: 0.3 to 1.9; P =0.62) with a 1-μg dose, and 0.5 (95% CI: 0.3 to 0.9; P =0. 03) with a 2-μg dose of paricalcitol. At 1 month, the treatment:baseline ratio of 24-hour albumin excretion rate was 1.35 (95% CI: 1.08 to 1.69; P =0.01) with placebo, 0.52 (95% CI: 0.40 to 0.69; P 〈 0.001) with a 1-μg dose, and 0.54 (95% CI: 0.35 to 0.83; P =0. 01) with a 2-μg dose ( P 〈 0.001 for between group changes). No differences were observed in iothalamate clearance, 24-hour ambulatory blood pressure, or parathyroid hormone with treatment or on washout. Thus, paricalcitol-induced reduction in albuminuria and inflammation may be mediated independent of its effects on hemodynamics or parathyroid hormone suppression. Long-term randomized, controlled trials are required to confirm these benefits of vitamin D analogs.
Type of Medium:
Online Resource
ISSN:
0194-911X
,
1524-4563
DOI:
10.1161/HYPERTENSIONAHA.108.113159
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2008
detail.hit.zdb_id:
2094210-2
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