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Paricalcitol and outcome: a manual on how a vitamin D receptor activator (VDRA) can help us to get down the "U".
Clin Nephrol. 2009 Jun; 71(6):593-601.CN

Abstract

Modern strategies to prevent secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients give great relevance to vitamin D replacement therapy. However, a sound approach to treatment requires taking into account many factors, including stage of CKD, underlying renal disorder, levels of circulating PTH, bone status, vitamin D deposits, and serum calcium (Ca) and phosphate (P) levels. The aim of vitamin D replacement therapy should be to prevent SHPT from the early stages of CKD, because once parathyroid hyperplasia and osteodystrophy develop, they cannot be completely reverted. The therapeutic strategies for SHPT are now changing. The availability of VDRAs allows inhibition of parathyroid glands with less effect on calcium and phosphate levels, and perhaps reduces the mortality of dialysis patients. Actual objectives for treating CKD patients with new generation VDRAs are to retain or amplify the effects of calcitriol on PTH suppression, with no effects on serum Ca and P levels. Paricalcitol is such a new VDRA with minimal impact on serum Ca and P levels. Since cardiovascular disease is the leading cause of morbidity and mortality in dialysis patients, these data suggest that the beneficial effect associated with paricalcitol injection on patient survival is at least partially related to its effect on the cardiovascular system.

Authors+Show Affiliations

Division of Nephrology, University of Milan, S Paolo Hospital, Milan, Italy. mariocozzolino@hotmail.comNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19473626

Citation

Cozzolino, M, and V Brandenburg. "Paricalcitol and Outcome: a Manual On How a Vitamin D Receptor Activator (VDRA) Can Help Us to Get Down the "U"." Clinical Nephrology, vol. 71, no. 6, 2009, pp. 593-601.
Cozzolino M, Brandenburg V. Paricalcitol and outcome: a manual on how a vitamin D receptor activator (VDRA) can help us to get down the "U". Clin Nephrol. 2009;71(6):593-601.
Cozzolino, M., & Brandenburg, V. (2009). Paricalcitol and outcome: a manual on how a vitamin D receptor activator (VDRA) can help us to get down the "U". Clinical Nephrology, 71(6), 593-601.
Cozzolino M, Brandenburg V. Paricalcitol and Outcome: a Manual On How a Vitamin D Receptor Activator (VDRA) Can Help Us to Get Down the "U". Clin Nephrol. 2009;71(6):593-601. PubMed PMID: 19473626.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paricalcitol and outcome: a manual on how a vitamin D receptor activator (VDRA) can help us to get down the "U". AU - Cozzolino,M, AU - Brandenburg,V, PY - 2009/5/29/entrez PY - 2009/5/29/pubmed PY - 2009/7/25/medline SP - 593 EP - 601 JF - Clinical nephrology JO - Clin Nephrol VL - 71 IS - 6 N2 - Modern strategies to prevent secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients give great relevance to vitamin D replacement therapy. However, a sound approach to treatment requires taking into account many factors, including stage of CKD, underlying renal disorder, levels of circulating PTH, bone status, vitamin D deposits, and serum calcium (Ca) and phosphate (P) levels. The aim of vitamin D replacement therapy should be to prevent SHPT from the early stages of CKD, because once parathyroid hyperplasia and osteodystrophy develop, they cannot be completely reverted. The therapeutic strategies for SHPT are now changing. The availability of VDRAs allows inhibition of parathyroid glands with less effect on calcium and phosphate levels, and perhaps reduces the mortality of dialysis patients. Actual objectives for treating CKD patients with new generation VDRAs are to retain or amplify the effects of calcitriol on PTH suppression, with no effects on serum Ca and P levels. Paricalcitol is such a new VDRA with minimal impact on serum Ca and P levels. Since cardiovascular disease is the leading cause of morbidity and mortality in dialysis patients, these data suggest that the beneficial effect associated with paricalcitol injection on patient survival is at least partially related to its effect on the cardiovascular system. SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/19473626/Paricalcitol_and_outcome:_a_manual_on_how_a_vitamin_D_receptor_activator__VDRA__can_help_us_to_get_down_the_"U"_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -