Comparative Efficacy of Oral and Intravenous Calcitriol Treatment in Haemodialysis Patients: Effects on Serum Biochemistry and Cytokine Levels

Borazan, Ali; Üstün, Hasan; Çefle, Ayşe; Sekitmez, Nedred; Yılmaz, Ahmet

doi:10.1177/147323000303100604

Cited by 24 publications

(20 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After calcitriol treatment, levels of serum iPTH and IL-6 also decreased significantly and in parallel. Our results are in keeping with the findings of Borazan et al [25] who showed that iPTH, IL-1 and IL-6 decreased after 6 months of intravenous calcitriol treatment. Our results indicate that increased serum iPTH levels may stimulate IL-6 production in HD patients.…”

Section: Discussionsupporting

confidence: 83%

“…In primary hyperparathyroidism, the parathyroid gland may contribute markedly to IL-6 production and elevation of serum IL-6 levels [9] . Although decreased elimination may be the major cause of elevated IL-6 levels in endstage renal disease patients, increased cytokine generation may also play a role [25] . Prior to calcitriol treatment, increased levels of serum iPTH and IL-6 levels were significantly correlated.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Calcitriol on Type 5b Tartrate-Resistant Acid Phosphatase and Interleukin-6 in Secondary Hyperparathyroidism

Tseng

et al. 2006

Blood Purif

View full text Add to dashboard Cite

Background/Aims: Secondary hyperparathyroidism (SHP) is characterized by high bone turnover and elevated serum bone remodeling markers. Elevation of serum interleukin-6 (IL-6) levels is also characteristic of end-stage renal disease. This study investigates the effects of intravenous calcitriol on serum bone resorptive markers, namely, type 5b tartrate-resistant acid phosphatase (TRACP5b) and IL-6 in patients with SHP. Methods: Intravenous calcitriol therapy was given for 16 weeks to 24 patients on maintenance hemodialysis with plasma intact parathyroid hormone (iPTH) levels >300 pg/ml. Blood was drawn at baseline and every 4 weeks for 16 weeks for determination of the levels of biochemical parameters, iPTH, IL-6 and bone remodeling markers, including bone-specific alkaline phosphatase (bAP) and TRACP5b. Results: Only 21 patients responded to the calcitriol therapy, with significant decrements in serum iPTH after 4 weeks of therapy and thereafter. After 16 weeks of calcitriol therapy, 21 patients had significant decrements in serum iPTH (707.9 ± 317.8 vs. 205.0 ± 63.1 pg/ml, p < 0.01). Prior to treatment, a significant correlation was found between increased levels of serum iPTH and IL-6 levels (r = 0.45, p < 0.05). After treatment, there was also a significant and parallel lowering of levels of serum iPTH, IL-6 (8.52 ± 3.59 vs. 7.24 ± 2.81 pg/ml, p < 0.01), bAP (54.68 ± 36.17 vs. 24.55 ± 13.84 U/l, p < 0.01) and TRACP5b (3.41 ± 1.89 vs. 1.80 ± 0.55 U/l, p < 0.01). Our results additionally showed significant positive correlationsbetween baseline levels of serum IL-6 and those of iPTH, bAP and TRACP5b. After 16 weeks of calcitriol treatment, the correlation between IL-6 and iPTH levels lost significance but levels of serum IL-6, bAP and TRACP5b remained significantly correlated. Conclusions: Elevated levels of serum IL-6 and bone remodeling markers, namely, bAP and TRACP5b which are common features of SHP, are effectively suppressed by calcitriol therapy. This indicates that hyperparathyroidism not only accelerates bone remodeling but may also aggravate inflammation in patients on maintenance hemodialysis.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Effects of Calcitriol on Type 5b Tartrate-Resistant Acid Phosphatase and Interleukin-6 in Secondary Hyperparathyroidism

Tseng

et al. 2006

Blood Purif

View full text Add to dashboard Cite

show abstract

“…Studies showed that hypovitaminosis D was associated with an enhanced inflammatory response manifested as significantly increased serum TNF-α, IL-6, and CRP levels in healthy [613][614][615][616] and obese persons [617,618]. Moreover, in some clinical states associated with inflammation, vitamin D supplementation caused a marked decrease in serum levels of these proinflammatory factors [619,620] and an increase in antiinflammatory cytokine IL-10 concentration [621]. 1,25(OH) 2 D 3 , vitamin D 3 analog, exerted direct action on purified mouse Langerhans cells reducing IL-10 production and enhancing the production of IL-6 and IL-12p40 upon activation by CD40 ligation [622].…”

Section: Vitamin D Deficiency Is Linked With Development Of Diabetes mentioning

confidence: 99%

T. gondii Infection Acquired during Pregnancy and/or after Birth may be Responsible for Development of both Type 1 and 2 Diabetes Mellitus

Pr¹,

ota²

2013

J Diabetes Metab

View full text Add to dashboard Cite

Recently, it was suggested that maternal T and potentially B cells transferred during pregnancy and/or the breast milk feeding and their encounter with the antigen in mesenteric lymph nodes might play a role in development of type 1 diabetes mellitus (T1DM). T. gondii infection during gestation and/or after birth may be responsible for development of both T1DM and T2DM in children, adolescents and adults because: a) maternal microchimerism in peripheral blood was demonstrated to be significantly higher in patients with T1DM compared to unaffected siblings and healthy subjects, b) transmission of T. gondii as a Trojan horse in various types of eukaryotic cells, including T and B lymphocytes, c) swallowing by the fetus of amniotic fluid containing infected leukocytes and other cells, d) elimination of T. gondii in the breast milk during lactation, e) involvement of mesenteric lymph nodes after oral infection with the parasite, and f) damage of the myenteric neurons during infection with the parasite in both the animals with streptozotocin-induced diabetes and diabetic patients. Moreover, a significantly lower occurrence of antibodies against T. gondii found in the sera of patients with T1DM compared with their first-degree family members or healthy controls may be due to their T and/or B cell exhaustion perspective caused by chronic infection with the parasite. This suggestion may be supported by the finding that latent toxoplasmosis was associated with markedly reduced lymphocyte B-cell counts responsible for production of antibodies, markedly lower serum IgG, IgM, and IgA levels, and a significant suppression of IL-2. On the other hand, patients with T2DM had increased anti-T. gondii antibodies significantly more frequently than respective controls. Impaired vascular endothelial function characteristic for the patients with diabetes mellitus may be at least in part due to the preferential T. gondii infection of endothelial cells. Vitamin D and minocycline exerted beneficial effects on development and clinical course of diabetes mellitus probably because of their immunomodulatory and antitoxoplasmatic activities. These data strongly suggest that the parasite play an important role in development of both types of diabetes mellitus.

show abstract

“…A administração intermitente parece ser mais efetiva para controlar os níveis de PTH do que a forma diária. 48,49 No entanto, não há um consenso na literatura sobre a melhor via de administração, assim como a melhor dose e frequência. Nos pacientes com HPS leve a moderado não há diferença entre o uso oral intermitente ou diário na redução dos níveis de PTH.…”

Section: Adendo Das Diretrizes Brasileiras De Prática Clínica Para O unclassified

Adendo das diretrizes brasileiras de prática clínica para o distúrbio mineral e ósseo na doença renal crônica capítulo 2

Carvalho¹,

Gueiros²,

Gueiros³

et al. 2012

J. Bras. Nefrol.

View full text Add to dashboard Cite

Prevention and treatment of secondary hyperparathyroidism in CKD das análises mostrarem uma tendência de elevação ou de descenso ou após a instituição do tratamento, seja ele para reduzir ou elevar os níveis de PTH (Opinião). 1.2 Deve-se aumentar a frequência de avaliação dos níveis séricos de PTH se os resultados das análises mostrarem uma tendência de elevação ou de descenso ou após a instituição do tratamento, seja ele para reduzir ou elevar os níveis de PTH (Opinião).1.3 A amostra de sangue para dosagem do PTH deverá ser obtida, preferencialmente em jejum. Nos pacientes em hemodiálise (HD), as amostras poderão ser obtidas no início da sessão de diálise (Opinião).1.4 Os laboratórios de análises clínicas devem informar ao médico qual o método que utilizam para a dosagem do PTH e, para cada método, qual a fonte ideal, se plasma ou soro, além das características ideais de coleta e armazenamento (Evidência).1.5 A frequência de dosagem da FA deve ser a mesma que a do PTH (Opinião).2 prevenção e trAtAmento do HiperpArAtireoidismo secundário nA drc pacieNtes com Drc estágios iii a v 2.1 Nos pacientes com DRC estágios III a V, os níveis ideais de PTH não são conhecidos. No entanto, sugerimos que os pacientes com níveis de PTH acima do limite superior de referência para o método, sejam avaliados quanto à presença de hipocalcemia, hiperfosfatemia ou fração de excreção de fósforo (P) elevada, e deficiência de 25-hidroxivitamina D (25-vit D). Se forem detectadas alterações nesses parâmetros, estes devem ser corrigidos; sais de Ca para correção da hipocalcemia, orientação dietética e/ou uso de quelantes de P para correção da hiperfosfatemia e uso de ergocalciferol (vitamina D 2 ) ou colecalciferol (vitamina D 3 ) para correção da hipovitaminose D (Evidência).

show abstract

Comparative Efficacy of Oral and Intravenous Calcitriol Treatment in Haemodialysis Patients: Effects on Serum Biochemistry and Cytokine Levels

Cited by 24 publications

References 19 publications

Effects of Calcitriol on Type 5b Tartrate-Resistant Acid Phosphatase and Interleukin-6 in Secondary Hyperparathyroidism

Effects of Calcitriol on Type 5b Tartrate-Resistant Acid Phosphatase and Interleukin-6 in Secondary Hyperparathyroidism

T. gondii Infection Acquired during Pregnancy and/or after Birth may be Responsible for Development of both Type 1 and 2 Diabetes Mellitus

Adendo das diretrizes brasileiras de prática clínica para o distúrbio mineral e ósseo na doença renal crônica capítulo 2

Contact Info

Product

Resources

About