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ARTICLE |

Calcifediol in Chronic Renal Insufficiency FREE

Jack W. Coburn, MD; Anthony W. Norman, PhD
JAMA. 1976;236(4):347-347. doi:10.1001/jama.1976.03270040013015
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To the Editor.—  The reader who is not highly familiar with the recent developments concerning vitamin D and its various active forms may be misled by certain comments made (235: 164, 1976) by Teitelbaum and associates.First, the major reason for the interest in the treatment of renal osteodystrophy with 1,25-dihydroxycholecalciferol (1,25-dihydroxy-vitamin D3 [1,25 {OH}2D3]) and 1α-hydroxycholecalciferol (1α-hydroxy-vitamin D3 [1α {OH} D3]) arises not because of "antirachitic properties of vitamin D in uremia," but because of discoveries that these compounds bypass the necessity for 1-hydroxylation in the kidney.1,2 Thus, the kidney is the only known organ capable of converting 25(OH)D3 to 1,25(OH)2D3, the most active, naturally occurring form of vitamin D; also, 1,25(OH)2D3 may account for all biologic actions heretofore ascribed to vitamin D itself. Moreover, a characteristic of renal osteodystrophy is a resistance to treatment

REFERENCES

Fraser DR, Kodicek E:  Unique biosynthesis by kidney of a biologically active vitamin D metabolite . Nature 228:764-766, 1970;.
Holick MF, Semmler EJ, Schnoes HK, et al:  1α-hydroxy derivative of vitamin D: A highly potent analog of lα,25-dihydroxy-vitamin D3 . Science 176:1247-1248, 1972;.
Gray RW, Weber HP, Dominguez JH, et al:  The metabolism of vitamin D3 and 25-Hydroxy vitamin D3 in normal and anephric humans . J Clin Endocrinol Metab 39:1045-1056, 1974;.
Brickman AS, Sherrard DJ, Jowsey J, et al:  Effect of 1,25-dihydroxycholecalciferol on skeletal lesions and plasma parathyroid hormones in uremic osteodystrophy . Arch Intern Med 134:883-888, 1974;.
Brickman AS, Sherrard DJ, Coburn JW, et al:  Management of renal osteodystrophy with 1,25(OH)2 and lα(OH)-vitamin D3: Experience with 36 patients , in Abstract Book, American Society of Nephrology, 8th Annual Meeting, November 1975 , p 11.
Uskokovic MR, Baggiolini E, Mahgoub A, et al:  Synthesis of vitamin D3 metabolites , in Norman AW, Schaefer K, Grigolent HG, et al (eds): Vitamin D and Problems Related to Uremic Bone Disease . Berlin, Walter de Gruyter & Co, 1975;, pp 279-283.

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Fraser DR, Kodicek E:  Unique biosynthesis by kidney of a biologically active vitamin D metabolite . Nature 228:764-766, 1970;.
Holick MF, Semmler EJ, Schnoes HK, et al:  1α-hydroxy derivative of vitamin D: A highly potent analog of lα,25-dihydroxy-vitamin D3 . Science 176:1247-1248, 1972;.
Gray RW, Weber HP, Dominguez JH, et al:  The metabolism of vitamin D3 and 25-Hydroxy vitamin D3 in normal and anephric humans . J Clin Endocrinol Metab 39:1045-1056, 1974;.
Brickman AS, Sherrard DJ, Jowsey J, et al:  Effect of 1,25-dihydroxycholecalciferol on skeletal lesions and plasma parathyroid hormones in uremic osteodystrophy . Arch Intern Med 134:883-888, 1974;.
Brickman AS, Sherrard DJ, Coburn JW, et al:  Management of renal osteodystrophy with 1,25(OH)2 and lα(OH)-vitamin D3: Experience with 36 patients , in Abstract Book, American Society of Nephrology, 8th Annual Meeting, November 1975 , p 11.
Uskokovic MR, Baggiolini E, Mahgoub A, et al:  Synthesis of vitamin D3 metabolites , in Norman AW, Schaefer K, Grigolent HG, et al (eds): Vitamin D and Problems Related to Uremic Bone Disease . Berlin, Walter de Gruyter & Co, 1975;, pp 279-283.
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