High doses of cholecalciferol alleviate the progression of hyperparathyroidism in patients with CKD Stages 3-4: results of a 12-week double-blind, randomized, controlled study

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Westerberg, Per-Anton,1967-Uppsala universitet,Njurmedicin,County Hospital, Jönköping, Sweden (author)

High doses of cholecalciferol alleviate the progression of hyperparathyroidism in patients with CKD Stages 3-4 : results of a 12-week double-blind, randomized, controlled study

Article/chapterEnglish2018

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2017-05-30
Oxford University Press (OUP),2018
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LIBRIS-ID:oai:DiVA.org:uu-342579
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-342579URI
https://doi.org/10.1093/ndt/gfx059DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Background: Calcidiol insufficiency may accelerate the development of secondary hyperparathyroidism (SHPT). We tested the effect of a substantial increase in calcidiol on mineral metabolism in patients with chronic kidney disease (CKD).Methods: Ninety-five patients with CKD Stages 3-4, parathyroid hormone (PTH) above 6.8 pmol/L and calcidiol below 75 nmol/L were randomized to receive either cholecalciferol 8000 IU/day or placebo for 12 weeks. The primary endpoint was difference in the mean change in iPTH after 12 weeks. The proportion of participants having a 30% reduction in PTH and the effect on hand grip strength, fatigue and different biochemical variables were also investigated.Results: Baseline calcidiol was 57.5 ± 22 and 56.8 ± 22 nmol/L in the cholecalciferol and placebo groups, respectively. The corresponding concentrations of PTH were 10.9 ± 5 and 13.1 ± 9 pmol/L. Calcidiol increased to 162 ± 49 nmol/L in patients receiving cholecalciferol, and PTH levels remained constant at 10.5 ± 5 pmol/L. In the placebo group, calcidiol remained stable and PTH increased to 15.2 ± 11 pmol/L. The mean change in PTH differed significantly between the two groups (P < 0.01). The proportion of subjects reaching a 30% decrease in PTH did not differ. No effect on grip strength, fatigue, phosphate or fibroblast growth factor 23 was observed. Cholecalciferol treatment resulted in stable calcium concentrations and a substantial increase in calcitriol.Conclusion: Treatment with high daily doses of cholecalciferol in patients with CKD Stages 3-4 halts the progression of SHPT and does not cause hypercalcaemia or other side effects.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
FGF23
cholecalciferol
chronic renal failure
secondary hyperparathyroidism
vitamin D

Added entries (persons, corporate bodies, meetings, titles ...)

Sterner, Gunnar (author)
Ljunggren, ÖstenUppsala universitet,Endokrinologi och mineralmetabolism(Swepub:uu)osteljun (author)
Isaksson, Elin (author)
Elvarson, FjölnirUppsala universitet,Institutionen för medicinska vetenskaper(Swepub:uu)fjoel918 (author)
Dezfoolian, Hamid (author)
Linde, TorbjörnUppsala universitet,Njurmedicin(Swepub:uu)torblind (author)
Uppsala universitetNjurmedicin (creator_code:org_t)

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In:Nephrology, Dialysis and Transplantation: Oxford University Press (OUP)33:3, s. 466-4710931-05091460-2385

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