Jejunal and ileal absorption in patients with chronic renal disease. Effect of 1alpha-hydroxycholecalciferol.

Vergne-Marini, P.; Parker, Thomas; Pak, Charles Y.C.; Hull, Alan R.; DeLuca, Hector F.; Fordtran, John S.

doi:10.1172/jci108362

Cited by 36 publications

(13 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, unlike the normalization in absorption that has been reported by others [27], both compounds at the doses we studied failed to produce even low normal values for Ca absorption. Our study confirmed significant differences in intestinal Ca absorption in hemodialysis patients; however, there were no significant differences in serum Ca or P at the end of each treatment period, possibly due to the poor sensitivity of serum Ca for detecting VDR activator-induced effects on mineral availability, which may explain the discrepancies reported in observational studies that relate serum Ca to outcomes [28,29].…”

Section: Discussioncontrasting

confidence: 93%

Differential Effects of Paricalcitol and Calcitriol on Intestinal Calcium Absorption in Hemodialysis Patients

et al. 2009

View full text Add to dashboard Cite

Background/Aims: Increased parathyroid activity associated with chronic kidney disease is often managed with calcitriol, which can elevate serum calcium (Ca) by increasing bone resorption and intestinal absorption, whereas paricalcitol promotes less bone resorption. This study compared intestinal Ca absorption in hemodialysis patients treated with calcitriol versus paricalcitol (dose ratio 1:3). Methods: Patients (n = 22) aged ≧20 years, on maintenance hemodialysis for ≧2 months with intact parathyroid hormone (iPTH) levels of >200 pg/ml were enrolled in a single-center, double-blind, active-controlled, randomized, crossover trial. Mean fractional intestinal Ca absorption (±SE) was measured by the single-tracer method (⁴²Ca) and evaluated with an analysis of variance crossover model. Results: Mean fractional intestinal Ca absorption was significantly lower after paricalcitol (0.135 ± 0.006) versus calcitriol treatment (0.158 ± 0.006, p = 0.022), a 0.023 difference in absolute Ca absorption fraction. Overall Ca absorption was low in the study population, indicating that regulation of Ca absorption may be dysfunctional. There were no significant differences in serum PTH, Ca, phosphorus (P), or Ca × P. Conclusion: Overall, paricalcitol-treated patients absorbed ∼14% less Ca compared with calcitriol-treated patients with similar effects on PTH. In hemodialysis patients, paricalcitol may provide a benefit by lowering the Ca available for removal by dialysis and/or for deposit in bone or soft tissues.

show abstract

Section: Discussioncontrasting

confidence: 93%

Differential Effects of Paricalcitol and Calcitriol on Intestinal Calcium Absorption in Hemodialysis Patients

et al. 2009

View full text Add to dashboard Cite

show abstract

“…This may result from the low level of calcitriol necessary for adequate gastrointestinal absorption of calcium [18] and the lack of its direct inhibitory effects on PTH synthe sis [7,8]. In secondary hyperparathyroidism, a higher serum calcium is needed to decrease PTH secretion com pared to normal (as evidenced by a higher set point).…”

Section: Discussionmentioning

confidence: 99%

Serum Parathyroid Hormone Suppression by Intravenous 1,25-Dihydroxy vitamin D3 in Patients on Maintenance Haemodialysis

Rassoul¹,

Mousa²,

Rehman³

et al. 1995

Am J Nephrol

View full text Add to dashboard Cite

Secondary hyperparathyroidism in patients with end-stage renal disease is characterised by elevated circulating levels of parathyroid hormone, due to inadequate synthesis of calcitriol, the active metabolite of vitamin D. Recent studies suggest that administration of calctriol may directly suppress parathyroid (PTH) secretion independent of changes in serum calcium. We have studied the effect of intravenous calcitriol administration on the PTH level in 14 patients on maintenance haemodialysis with serum PTH levels above 2,000 pmol/l over a 16-week period. There was a significant reduction in the PTH level (65%) and a rise of serum calcium to the normal range. There was a significant reduction in serum PTH levels before the serum calcium concentrations increased, suggesting that calcitriol directly inhibits PTH release. In conclusion, intravenous treatment with calcitriol is of clinical importance, because it suppresses hypersecretion of PTH in uraemic patients, with minimal side effects.

show abstract

“…The median (IQR) FxAbs was 12% (7-17) at baseline and 12% (7)(8)(9)(10)(11)(12)(13)(14)(15)(16) at the end of study ( Table 2). The median withinsubject change was 0.01% (20.05-0.03).…”

Section: Calcium Absorptionmentioning

confidence: 99%

“…However, despite the potential benefits of vitamin D supplementation, there is also a concern that it may lead to hypercalcemia and ectopic calcification by raising 1,25(OH) 2 D levels (9) and increasing active intestinal calcium absorption (10).…”

Section: Introductionmentioning

confidence: 99%

Calcium Absorption Response to Cholecalciferol Supplementation in Hemodialysis

Armas

Zena

Lund

et al. 2013

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives Recent understanding of extrarenal production of calcitriol has led to the use of more vitamin D supplementation in CKD populations. This paper reports the effect of cholecalciferol supplementation on calcium absorption.Design, setting, participants, & measurements Paired calcium absorption tests were done before and after 12-13 weeks of 20,000 IU weekly cholecalciferol supplementation in 30 participants with stage 5 CKD on hemodialysis. The study was conducted from April to December of 2011. Calcium absorption was tested with a standardized meal containing 300 mg calcium carbonate intrinsically labeled with 45 Ca; 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were measured.Results 25-Hydroxyvitamin D rose from 14.2 ng/ml (11.5-18.5) at baseline to 49.3 ng/ml (42.3-58.1) at the end of the study (P,0.001). 1,25-Dihydroxyvitamin D rose from 15.1 (10.5-18.8) pg/ml at baseline to 20.5 (17.0-24.7) pg/ml at the end of the study (P,0.001). The median baseline calcium absorption was 12% (7%-17%) and 12% (7%-16%) at the end of study.Conclusions Patients with stage 5 CKD on hemodialysis had very low calcium absorption values at baseline, and cholecalciferol supplementation that raised 25(OH)D levels to 50 ng/ml had no effect on calcium absorption.

show abstract

Jejunal and ileal absorption in patients with chronic renal disease. Effect of 1alpha-hydroxycholecalciferol.

Cited by 36 publications

References 31 publications

Differential Effects of Paricalcitol and Calcitriol on Intestinal Calcium Absorption in Hemodialysis Patients

Differential Effects of Paricalcitol and Calcitriol on Intestinal Calcium Absorption in Hemodialysis Patients

Serum Parathyroid Hormone Suppression by Intravenous 1,25-Dihydroxy vitamin D3 in Patients on Maintenance Haemodialysis

Calcium Absorption Response to Cholecalciferol Supplementation in Hemodialysis

Contact Info

Product

Resources

About