Is Calcitriol [1,25(OH)2D3] Harmful to Renal Function? FREE

[+] Author Affiliations

From the Division of Nephrology, Department of Medicine, University of Southern California School of Medicine, Los Angeles.

Reprint requests to Division of Nephrology, University of Southern California School of Medicine, 2025 Zonal Ave, Los Angeles, CA 90033 (Dr Massry).

JAMA. 1979;242(17):1875-1876. doi:10.1001/jama.1979.03300170021019

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ABSTRACT

ABSTRACT | REFERENCES

IT HAS long been known that patients with advanced renal failure require large doses of vitamin D for the expression of its biological effects.¹ The discovery by Fraser and Kodicek² that the kidney is responsible for the production of the active metabolite of vitamin D, 1,25(OH)₂D₃, provided an explanation for the vitamin D-resistant state in patients with chronic uremia and implied that such patients have a deficiency of 1,25(OH)₂D₃. Indeed, Brumbaugh et al³ found that the blood levels of this metabolite in patients with chronic renal failure are low or undetectable.

The successful chemical synthesis of calcitriol made this metabolite available for replacement therapy, and its clinical use has recently been approved for the treatment of patients receiving dialysis.

Since a deficiency of 1,25(OH)₂D₃ is present in patients who have advanced renal failure but who as yet do

REFERENCES

ABSTRACT | REFERENCES

Liu SH, Chu HI: Studies of calcium and phosphorus metabolism with special reference to pathogenesis and effects of dihydrotachysterol (A.T. 10) and iron . Medicine 22:103-161, 1943;.

Fraser DR, Kodicek E: Unique biosynthesis by kidney of a biologically active vitamin D metabolite . Nature 228:764-766, 1970;.

Brumbaugh PF, Haussler DH, Bressler R, et al: Radioreceptor assay for 1α-25-dihydroxyvitamin D, . Science 183:1089-1091, 1974;.

Tougaard L, Sorensen E, Brochner-Mortensen J, et al: Controlled trial of 1α-hydroxycholecalciferol in chronic renal failure . Lancet 1:1044-1047, 1976;.

Christiansen C, Rødbro P, Christensen MS, et al: Deterioration of renal function during treatment of chronic renal failure with 1,25-dihydroxycholecalciferol . Lancet 2:700-703, 1978;.

Massry SG: Effects of electrolyte disorders on the kidney , in Earley LE, Gottschalk CW (eds): Strauss and Welt's Diseases of the Kidney , ed 3. Boston, Little Brown & Co, 1979;, pp 1403-1430.

Winterborn MH, Mace PJ, Heath DA, et al: Impairment of renal function in patients on 1α-hydroxycholecalciferol . Lancet 2:150-151, 1978;.

Compston JE, Horton LW, Laker MF: Vitamin D analogues and renal failure . Lancet 1:386, 1979;.

Lund B, Sorensen OH, Lund B: 1α-Hydroxycholecalciferol and renal function . Lancet 2:731, 1978;.

Nordin BEC: Vitamin D analogues and renal function . Lancet 2:1259, 1978;.

Farrington K, Varghese Z, Moorhead JF: Vitamin D analogues and renal function . Lancet 2:941, 1978;.

Healy M, Malluche HH, Goldstein DA, et al: The prophylactic use of 1,25(OH)2D3 in moderate renal failure , abstracted. Clin Res 27:62, 1979;.

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