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Calcitriol and doxercalciferol are equivalent in controlling bone turnover, suppressing parathyroid hormone, and increasing fibroblast growth factor-23 in secondary hyperparathyroidism.
Kidney Int. 2011 Jan; 79(1):112-9.KI

Abstract

We compared the effects of calcitriol and doxercalciferol, in combination with either calcium carbonate or sevelamer, on bone, mineral, and fibroblast growth factor-23 (FGF-23) metabolism in patients with secondary hyperparathyroidism. A total of 60 pediatric patients treated with peritoneal dialysis were randomized to 8 months of therapy with either oral calcitriol or doxercalciferol, combined with either calcium carbonate or sevelamer. Bone formation rates decreased during therapy and final values were within the normal range in 72% of patients. A greater improvement in eroded surface was found in patients treated with doxercalciferol than in those given calcitriol. On initial bone biopsy, a mineralization defect was identified in the majority of patients which did not normalize with therapy. Serum phosphate concentrations were controlled equally well by both binders, but serum calcium levels increased during treatment with calcium carbonate, and serum parathyroid hormone levels were decreased by 35% in all groups. Baseline plasma FGF-23 values were significantly elevated and rose over fourfold with calcitriol and doxercalciferol, irrespective of phosphate binder. Thus, doxercalciferol is as effective as calcitriol in controlling serum parathyroid hormone levels and suppressing the bone formation rate. Sevelamer allows the use of higher doses of vitamin D. Implications of these changes on bone and cardiovascular biology remain to be established.

Authors+Show Affiliations

Division of Pediatric Nephrology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA. kwesseling@mednet.ucla.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20861820

Citation

Wesseling-Perry, Katherine, et al. "Calcitriol and Doxercalciferol Are Equivalent in Controlling Bone Turnover, Suppressing Parathyroid Hormone, and Increasing Fibroblast Growth Factor-23 in Secondary Hyperparathyroidism." Kidney International, vol. 79, no. 1, 2011, pp. 112-9.
Wesseling-Perry K, Pereira RC, Sahney S, et al. Calcitriol and doxercalciferol are equivalent in controlling bone turnover, suppressing parathyroid hormone, and increasing fibroblast growth factor-23 in secondary hyperparathyroidism. Kidney Int. 2011;79(1):112-9.
Wesseling-Perry, K., Pereira, R. C., Sahney, S., Gales, B., Wang, H. J., Elashoff, R., Jüppner, H., & Salusky, I. B. (2011). Calcitriol and doxercalciferol are equivalent in controlling bone turnover, suppressing parathyroid hormone, and increasing fibroblast growth factor-23 in secondary hyperparathyroidism. Kidney International, 79(1), 112-9. https://doi.org/10.1038/ki.2010.352
Wesseling-Perry K, et al. Calcitriol and Doxercalciferol Are Equivalent in Controlling Bone Turnover, Suppressing Parathyroid Hormone, and Increasing Fibroblast Growth Factor-23 in Secondary Hyperparathyroidism. Kidney Int. 2011;79(1):112-9. PubMed PMID: 20861820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcitriol and doxercalciferol are equivalent in controlling bone turnover, suppressing parathyroid hormone, and increasing fibroblast growth factor-23 in secondary hyperparathyroidism. AU - Wesseling-Perry,Katherine, AU - Pereira,Renata C, AU - Sahney,Shobha, AU - Gales,Barbara, AU - Wang,He-Jing, AU - Elashoff,Robert, AU - Jüppner,Harald, AU - Salusky,Isidro B, Y1 - 2010/09/22/ PY - 2010/9/24/entrez PY - 2010/9/24/pubmed PY - 2011/4/19/medline SP - 112 EP - 9 JF - Kidney international JO - Kidney Int VL - 79 IS - 1 N2 - We compared the effects of calcitriol and doxercalciferol, in combination with either calcium carbonate or sevelamer, on bone, mineral, and fibroblast growth factor-23 (FGF-23) metabolism in patients with secondary hyperparathyroidism. A total of 60 pediatric patients treated with peritoneal dialysis were randomized to 8 months of therapy with either oral calcitriol or doxercalciferol, combined with either calcium carbonate or sevelamer. Bone formation rates decreased during therapy and final values were within the normal range in 72% of patients. A greater improvement in eroded surface was found in patients treated with doxercalciferol than in those given calcitriol. On initial bone biopsy, a mineralization defect was identified in the majority of patients which did not normalize with therapy. Serum phosphate concentrations were controlled equally well by both binders, but serum calcium levels increased during treatment with calcium carbonate, and serum parathyroid hormone levels were decreased by 35% in all groups. Baseline plasma FGF-23 values were significantly elevated and rose over fourfold with calcitriol and doxercalciferol, irrespective of phosphate binder. Thus, doxercalciferol is as effective as calcitriol in controlling serum parathyroid hormone levels and suppressing the bone formation rate. Sevelamer allows the use of higher doses of vitamin D. Implications of these changes on bone and cardiovascular biology remain to be established. SN - 1523-1755 UR - https://www.unboundmedicine.com/medline/citation/20861820/Calcitriol_and_doxercalciferol_are_equivalent_in_controlling_bone_turnover_suppressing_parathyroid_hormone_and_increasing_fibroblast_growth_factor_23_in_secondary_hyperparathyroidism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)54678-4 DB - PRIME DP - Unbound Medicine ER -