High-dose alfacalcidol improves anaemia in patients on haemodialysis

Albitar, Sami; Genin, R; Fen-Chong, M; Serveaux, Marie-Odile; Schohn, D; Chuet, C

doi:10.1093/ndt/12.3.514

Cited by 73 publications

(70 citation statements)

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“…It has been previously shown that these can be ameliorated by a reduction in the frequency of bisphosphonate (alendronate) dosing. 25,26 An important adverse effect shown by previous studies to be associated with alfacalcidol is hypercalcaemia, 27,28 although this adverse effect was not seen in the present study. The percentage increases in serum 25-hydroxyvitamin D 3 levels in both study groups were very large in the present study, whereas the percentage changes in serum calcium concentrations were very small.…”

Section: Discussioncontrasting

confidence: 63%

The Safety and Efficacy of Early-Stage Bi-Weekly Alendronate to Improve Bone Mineral Density and Bone Turnover in Chinese Post-Menopausal Women at Risk of Osteoporosis

Chen

et al. 2011

J Int Med Res

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The efficacy and safety of early, low frequency antiresorptive drug intervention for osteopaenia on bone mineral density (BMD) and bone turnover in Chinese post-menopausal women at risk of developing osteoporosis were investigated. A total of 180 women aged 40 -70 years were enrolled and equally randomized to receive either 70 mg alendronate once every 2 weeks plus 0.5 µg alfacalcidol daily (treatment group) or alfacalcidol 0.5 µg daily alone (control group) for 12 months. In the treatment group, lumbar spine and total hip BMD at 12 months had increased significantly from baseline and compared with the control group. There were also significant reductions in serum levels of the bone turnover biomarkers, bone-specific alkaline phosphatase and C-terminal telopeptide of type I collagen, compared with the control. No serious adverse events were observed in either group and safety profiles were similar. It was concluded that early intervention with 70 mg alendronate once every 2 weeks was safe, well tolerated and more effective than alfacalcidol alone (control) in increasing BMD and reducing bone turnover, and might prevent serious outcomes, such as fragility fractures, reduce rates of adverse effects and improve patient compliance.

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Section: Discussioncontrasting

confidence: 63%

The Safety and Efficacy of Early-Stage Bi-Weekly Alendronate to Improve Bone Mineral Density and Bone Turnover in Chinese Post-Menopausal Women at Risk of Osteoporosis

Chen

et al. 2011

J Int Med Res

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“…Infants' Hb level, serum Fe as well as 25(OH)D concentrations were increased after they were treated with intramuscular iron dextran (13) . Studies on patients with chronic kidney disease have also supported this association (14,15) .…”

mentioning

confidence: 85%

Hb level in relation to vitamin D status in healthy infants and toddlers

Abdul‐Razzak

Khoursheed

Altawalbeh

et al. 2012

Public Health Nutr.

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“…In many cases the correction of HPT in response to therapy avoids the need for parathyroidectomy and also improves the response to rHu-Epo in dialysis patients. This latter effect has been related to the control of HPT [4]. However, calcitriol (C) has been shown to improve anaemia without any correlation between parathyroid hormone levels and rHu-Epo requirement [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Calcitriol Increases Burst-Forming Unit-Erythroid Proliferation in Chronic Renal Failure

Aucella¹,

Scalzulli

Gatta³

et al. 2004

Nephron Clin Pract

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Background: Calcitriol (C) improves anemia in chronic renal failure. This effect may be related to the suppression of iPTH release, or to a direct effect on erythropoiesis. Methods: Thirty-three patients with chronic renal failure were enrolled; among them, 24 were on chronic hemodialysis and 9 on conservative management. None had other chronic or hematological disease, aluminum levels were below 20 µg/l and DFO testing was negative. The iPTH range was 250–480 pg/l. None were treated with C or r-HuEpo. In vitro study: Samples were drawn for a basal erythroid precursor (burst forming unit-erythroid BFU-E) study: Mononuclear cells were incubated for 14 days with r-HuEpo 3U/ml (A), r-HuEpo 3U/l + C 30 pg (B), r-HuEpo 3U/ml + C 300 pg (C), or r-HuEpo 30 U/ml + C 300 pg (D). In vivo study: After the basal evaluation, 10 patients on chronic dialysis were treated with C (Calcijex-Abbott) 1 µg three times a week, and 4 patients served as controls. BFU-E studies were performed after 1, 2 and 4 months. Results: In vitro, culture B showed increased BFU-E proliferation vs. A (41 ± 23 vs. 27 ± 15, p < 0.02); in cultures C and D, proliferation was 61 ± 31 and 78 ± 42, respectively, p < 0.01 vs. A. There was no difference among patients with predialysis renal failure and those on dialysis. BFU-E proliferation was inversely related to basal Hb (p < 0.04) and CRP levels (p < 0.05). During the in vivo study, all cultures showed a progressive increase in proliferation without a plateau level (basal, after 1, 2 and 4 months, respectively) In A: 17 ± 8, 22 ± 13, 30.9 ± 14.9, 41.4 ± 20; in B: 27.3 ± 15, 35.6 ± 20, 45.5 ± 21, 57 ± 26; in C: 48.2 ± 20.6, 63.7 ± 32, 75.7 ± 37, 83 ± 40; in D: 72 ± 24, 91 ± 42, 106 ± 42, 110 ± 42.3 (all p < 0.001). Hb and Hct showed a significant increase (p < 0.03) in the treatment group. The decrease in iPTH was not related to BFU-E proliferation. Conclusions: In chronic uremia, C has a direct effect on erythroid precursors proliferation, as demonstrated both in vitro and in vivo, with a synergistic effect with r-HuEpo. C may be a useful adjuvant therapy to r-HuEpo treatment.

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High-dose alfacalcidol improves anaemia in patients on haemodialysis

Abstract: High-dose alfacalcidol is efficient in anaemic patients with moderate hyperparathyroidism on maintenance HD and has a direct effect on erythropoietic cells regardless of serum calcium and iPTH levels.

Cited by 73 publications

References 0 publications

The Safety and Efficacy of Early-Stage Bi-Weekly Alendronate to Improve Bone Mineral Density and Bone Turnover in Chinese Post-Menopausal Women at Risk of Osteoporosis

The Safety and Efficacy of Early-Stage Bi-Weekly Alendronate to Improve Bone Mineral Density and Bone Turnover in Chinese Post-Menopausal Women at Risk of Osteoporosis

Hb level in relation to vitamin D status in healthy infants and toddlers

Calcitriol Increases Burst-Forming Unit-Erythroid Proliferation in Chronic Renal Failure

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