Impact of calcium and vitamin D therapy on arterial and cardiac disease in young adults with childhood-onset end stage renal disease

Fournier, A; Harbouche, L.; Mansour, J.; Shahapuni, Irina

doi:10.1093/ndt/gfl692

Cited by 19 publications

(11 citation statements)

References 4 publications

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“…Besides playing an important role in the management of secondary hyperparathyroidism and bone mineralization, the impact of vitamin D therapy on arterial and cardiac disease has been emphasized in recent studies [21,26]. Vitamin D insufficiency is now considered a nontraditional risk factor for cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

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Vitamin D insufficiency and hyperparathyroidism in children with chronic kidney disease

et al. 2008

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Chronic kidney disease (CKD) is associated with altered calcium-phosphate homeostasis and hyperparathyroidism due to decreased activity of 1alpha-hydroxylase and impaired activation of 25-hydroxyvitamin D3 [25(OH)D3]. In some patients these problems start earlier because of vitamin D deficiency. A retrospective review of patients followed in the chronic renal insufficiency clinic at Children's Hospital of Michigan assessed the prevalence of vitamin D deficiency in CKD stages 2-4 and evaluated the effect of treatment with ergocalciferol on serum parathormone (PTH). Blood levels of 1,25 dihydroxyvitamin D3, 25(OH)D3, and parathormone (PTH) were examined in 57 children (40 boys; mean age 10.6 years). Of 57 subjects, 44 (77.2%) had 25(OH)D3 levels < or =30 ng/ml, with overall mean of 26.4 +/- 14.3 ng/ml. PTH for patients with 25(OH)D3 levels >30 ng/ml was 67.84 +/- 29.09 ng/ml and in the remaining patients was elevated, at 120.36 +/- 86.42 ng/ml (p = 0.05). Following ergocalciferol treatment (22), PTH decreased from 122.13 +/- 82.94 ng/ml to 80.14 +/- 59.24 ng/ml (p < 0.001) over a period of 3 months. We conclude that vitamin D deficiency is common in children with CKD stages 2-4 and is associated with hyperparathyroidism in the presence of normal 1,25 dihydroxyvitamin D3. Its occurrence before significant renal impairment is noteworthy. Early diagnosis and appropriate treatment is emphasized.

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Section: Discussionmentioning

confidence: 99%

“…Vitamin D insufficiency is now considered a nontraditional risk factor for cardiovascular disease. The beneficial effects of vitamin D are believed to be mediated by its antiinflammatory effect, down regulation of remodeling, proliferation of vascular endothelium and myocardium, and modulation of renin-angiotensin activity [26].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D insufficiency and hyperparathyroidism in children with chronic kidney disease

et al. 2008

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“…The number of patients who achieved the target level was significantly increased in the study group from the 8th week of supplementation (Table 3). Clinical studies of dialysis patients with SHPT also reported that the combined use of nutritional vitamin D might reduce the active vitamin D doses required for SHPT control and related adverse effects [2,31,32]. However, studies on the effective dosage of vitamin D supplementation for SHPT remain controversial [33,34,35].…”

Section: Discussionmentioning

confidence: 99%

Cholecalciferol Additively Reduces Serum Parathyroid Hormone and Increases Vitamin D and Cathelicidin Levels in Paricalcitol-Treated Secondary Hyperparathyroid Hemodialysis Patients

et al. 2016

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Background: Active Vitamin D analogues are used clinically for prevention and treatment of secondary hyperparathyroidism (SHPT) in hemodialysis (HD) patients. Nutritional vitamin D supplementation is used for additional local parathyroid (PTH) suppression, with lower incidence of hypercalcemia and hyperphosphatemia. This study evaluates the possible beneficial effects of combined vitamin D treatment (paricalcitol and cholecalciferol). Methods: Sixty HD patients with serum parathyroid hormone (iPTH) >300 pg/mL were enrolled. All patients administered 2 mcg/day of paricalcitol and were randomly allocated into control group (placebo) or study group (cholecalciferol) for 16 weeks. Serum 25(OH)D3, iPTH and human cathelicidin (hCAP-18) were measured at baseline and during follow-up. Results: iPTH levels decreased in the study group appropriately and were more significantly decreased at 16 weeks. Study group had significantly increased 25(OH)D3 levels. In addition, the study group had significantly increased serum hCAP-18 levels compared with control group. Correlation analysis showed a significant correlation between the percentage increase in serum hCAP-18 and 25(OH)D3 levels. Conclusions: Cholecalciferol, in combination with paricalcitol, additively lowers the iPTH levels in a significant number of patients after 16 weeks of supplementation. A dose of 5000 IU/week of cholecalciferol could maintain serum 25(OH)D3 levels above 30 ng/dL as early as 8 weeks after beginning supplementation. Doubling of serum cathelicidin levels were noted after 16 weeks of cholecalciferol supplementation in 40% of study patients.

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“…También es importante recordar que el défi cit de vitamina D es considerado en la actualidad como un factor de riesgo no tradicional de enfermedad cardiovascular y por ello su monitorización es esencial en la población de ERC, ya que al no reconocerla ni tratarla adicionamos un factor de riesgo más a los ya conocidos para enfermedad cardiovascular en esta población 11,20 . Adicionalmente, muchos estudios también demuestran la clara correlación que existe entre hipovitaminosis D y debilidad muscular por sarcopenia, efecto en el status inmunológico y riesgo asociado de ciertas neoplasias 12 .…”

Section: Discussionunclassified

Hipovitaminosis D en pacientes pediátricos en terapia de sustitución renal

et al. 2011

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Impact of calcium and vitamin D therapy on arterial and cardiac disease in young adults with childhood-onset end stage renal disease

Cited by 19 publications

References 4 publications

Vitamin D insufficiency and hyperparathyroidism in children with chronic kidney disease

Vitamin D insufficiency and hyperparathyroidism in children with chronic kidney disease

Cholecalciferol Additively Reduces Serum Parathyroid Hormone and Increases Vitamin D and Cathelicidin Levels in Paricalcitol-Treated Secondary Hyperparathyroid Hemodialysis Patients

Hipovitaminosis D en pacientes pediátricos en terapia de sustitución renal

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