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January 12, 1976, Vol 235, No. 2 >
ARTICLE | January 12, 1976

Calcifediol in Chronic Renal Insufficiency: Title and subTitle BreakSkeletal Response FREE

Steven L. Teitelbaum, MD; J. Michael Bone, MD; Paul M. Stein, MD; Jerome J. Gilden, MD; Margaret Bates; Vincenza C. Boisseau; Louis V. Avioli, MD
[+] Author Affiliations

Reprint requests to 216 S Kingshighway, St Louis, MO 63110 (Dr Teitelbaum).


JAMA. 1976;235(2):164-167. doi:10.1001/jama.1976.03260280022019
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References

Quantitative histology of thin, nondecalcified sections was performed on squential bone biopsy specimens from five patients undergoing long-term hemodialysis and treated with calcifediol (25-hydroxycholecalciferol) for periods of three to nine months. With increase of intestinal absorption of calcium and decline of circulating immunoreactive parathyroid hormone and alkaline phosphatase, the bones of each patient exhibited striking histological improvement. The group as a whole showed statistically significant decreases in osteoclast number and in the percentages of osteoid surface covered by active osteoblasts. Marrow fibrosis was either eliminated or strikingly decreased in each patient. Osteoid volume significantly declined in four of five patients. In patients with osteitis fibrosa as the predominant histological lesion, calcifediol therapy resulted in decreased calcification front activity. Increased activity was the result when osteomalacia predominated.

(JAMA 235:164-167, 1976)

REFERENCES

1 +
Lumb GA, Mawer EB, Stanbury SW:  The apparent vitamin D resistance of chronic renal failure: A study of the physiology of vitamin D in man . Am J Med 50:421-441, 1971;.
2 +
Russell JE, Avioli LV:  A therapeutic role for dechloromethylene diphosphonate (Cl2MDP) and 25-hydroxycholecalciferol (25HCC) in renal osteodystrophy . Clin Res 20:803, 1972;.
3 +
Balsan S, Wittmer G:  Treatment of renal osteodystrophy with 25-hydroxycholecalciferol . Second International Symposium of Pediatric Nephrology . Laboratories Sandoz, Rueil-Malmaison, France 1971;, p 108.
4 +
Eastwood JB, Bordier PJ, Clarkson EM, et al:  The contrasting effect on bone histology of vitamin D and of calcium carbonate in the osteomalacia of chronic renal failure . Clin Sci Mol Med 47:23-42, 1974;.
5 +
Chalmers TM, Davie MW, Hunter JO, et al:  1-Alpha-hydroxycholecalciferol as a substrate for the kidney hormone 1,25-dihydroxycholecalciferol in chronic renal failure . Lancet 2:696-699, 1973;.
6 +
Peacock M, Gallagher JC, Nordin BEC:  Action of 1-a-hydroxy vitamin D3 on calcium absorption and bone resorption in man . Lancet 1:385-389, 1974;.
7 +
Brickman AS, Sherrard DJ, Jowsey J, et al:  1,25 di-hydroxycholecalciferol: Effect on skeletal lesions and plasma parathyroid hormone levels in uremic osteodystrophy . Arch Intern Med 134:883-888, 1974;.
8 +
Henderson RG, Russell RGG, Ledingham JGG, et al:  Effects of 1,25 dihydroxycholecalciferol on calcium absorption, muscle weakness and bone disease in chronic renal failure . Lancet 1:379-384, 1974;.
9 +
DeLuca HF:  Vitamin D-1973 . Am J Med 57:1-12, 1974;.
10 +
Russell JR, Termine JD, Avioli LV:  Experimental renal osteodystrophy: The response to 25-hydroxycholecalciferol and dichloromethylene therapy . J Clin Invest , to be published.
11 +
Bordier PJ, Hioco D, Rouquier M, et al:  Effects of intravenous vitamin D on bone and phosphate metabolism in osteomalacia . Calcif Tissue Res 4:78-83, 1969;.
12 +
Teitelbaum SL, Rosenberg EM, Bates M, et al:  The effects of phosphate and vitamin D therapy on osteopenic, hypophosphatemic osteomalacia of childhood: A morphometric study . Clin Orthop , to be published.
13 +
Weisbrode SE, Capen CC, Nagode LA:  Ultrastructural evaluation of the effects of vitamin D and uremia on bone in the rat . Am J Pathol 76:359-369, 1974;.
14 +
Rolle GK:  The distribution of calcium in normal and tetracycline modified bones of developing chick embryos . Calcif Tissue Res 3:142-150, 1969;.
15 +
Russell JE, Avioli LV:  Effect of chronic renal insufficiency on bone mineral and collagen maturation . J Clin Invest 51:3072-3079, 1972;.
16 +
Oldham SB, Arnaud CD, Jowsey J:  The influence of vitamin D on parathyroid glands (PTGs) . Clin Res 21:254, 1973;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
Lumb GA, Mawer EB, Stanbury SW:  The apparent vitamin D resistance of chronic renal failure: A study of the physiology of vitamin D in man . Am J Med 50:421-441, 1971;.
2 +
Russell JE, Avioli LV:  A therapeutic role for dechloromethylene diphosphonate (Cl2MDP) and 25-hydroxycholecalciferol (25HCC) in renal osteodystrophy . Clin Res 20:803, 1972;.
3 +
Balsan S, Wittmer G:  Treatment of renal osteodystrophy with 25-hydroxycholecalciferol . Second International Symposium of Pediatric Nephrology . Laboratories Sandoz, Rueil-Malmaison, France 1971;, p 108.
4 +
Eastwood JB, Bordier PJ, Clarkson EM, et al:  The contrasting effect on bone histology of vitamin D and of calcium carbonate in the osteomalacia of chronic renal failure . Clin Sci Mol Med 47:23-42, 1974;.
5 +
Chalmers TM, Davie MW, Hunter JO, et al:  1-Alpha-hydroxycholecalciferol as a substrate for the kidney hormone 1,25-dihydroxycholecalciferol in chronic renal failure . Lancet 2:696-699, 1973;.
6 +
Peacock M, Gallagher JC, Nordin BEC:  Action of 1-a-hydroxy vitamin D3 on calcium absorption and bone resorption in man . Lancet 1:385-389, 1974;.
7 +
Brickman AS, Sherrard DJ, Jowsey J, et al:  1,25 di-hydroxycholecalciferol: Effect on skeletal lesions and plasma parathyroid hormone levels in uremic osteodystrophy . Arch Intern Med 134:883-888, 1974;.
8 +
Henderson RG, Russell RGG, Ledingham JGG, et al:  Effects of 1,25 dihydroxycholecalciferol on calcium absorption, muscle weakness and bone disease in chronic renal failure . Lancet 1:379-384, 1974;.
9 +
DeLuca HF:  Vitamin D-1973 . Am J Med 57:1-12, 1974;.
10 +
Russell JR, Termine JD, Avioli LV:  Experimental renal osteodystrophy: The response to 25-hydroxycholecalciferol and dichloromethylene therapy . J Clin Invest , to be published.
11 +
Bordier PJ, Hioco D, Rouquier M, et al:  Effects of intravenous vitamin D on bone and phosphate metabolism in osteomalacia . Calcif Tissue Res 4:78-83, 1969;.
12 +
Teitelbaum SL, Rosenberg EM, Bates M, et al:  The effects of phosphate and vitamin D therapy on osteopenic, hypophosphatemic osteomalacia of childhood: A morphometric study . Clin Orthop , to be published.
13 +
Weisbrode SE, Capen CC, Nagode LA:  Ultrastructural evaluation of the effects of vitamin D and uremia on bone in the rat . Am J Pathol 76:359-369, 1974;.
14 +
Rolle GK:  The distribution of calcium in normal and tetracycline modified bones of developing chick embryos . Calcif Tissue Res 3:142-150, 1969;.
15 +
Russell JE, Avioli LV:  Effect of chronic renal insufficiency on bone mineral and collagen maturation . J Clin Invest 51:3072-3079, 1972;.
16 +
Oldham SB, Arnaud CD, Jowsey J:  The influence of vitamin D on parathyroid glands (PTGs) . Clin Res 21:254, 1973;.

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