TY  - JOUR
T1  - Vitamin d therapy and cardiac structure and function in patients with chronic kidney disease: The primo randomized controlled trial
AU  - Thadhani R, Appelbaum E, Pritchett Y, et al
Y1  - 2012/02/15
N1  - 10.1001/jama.2012.120
JO  - JAMA
SP  - 674
EP  - 684
VL  - 307
IS  - 7
N2  - Context 
                  Vitamin D is associated with decreased cardiovascular-related morbidity and mortality, possibly by modifying cardiac structure and function, yet firm evidence for either remains lacking.Objective 
                  To determine the effects of an active vitamin D compound, paricalcitol, on left ventricular mass over 48 weeks in patients with an estimated glomerular filtration rate of 15 to 60 mL/min/1.73 m2.Design, Setting, and Participants 
                  Multinational, double-blind, randomized placebo-controlled trial among 227 patients with chronic kidney disease, mild to moderate left ventricular hypertrophy, and preserved left ventricular ejection fraction, conducted in 11 countries from July 2008 through September 2010.Intervention 
                  Participants were randomly assigned to receive oral paricalcitol, 2 μg/d (n =115), or matching placebo (n = 112).Main Outcome Measures 
                  Change in left ventricular mass index over 48 weeks by cardiovascular magnetic resonance imaging. Secondary end points included echocardiographic changes in left ventricular diastolic function.Results 
                  Treatment with paricalcitol reduced parathyroid hormone levels within 4 weeks and maintained levels within the normal range throughout the study duration. At 48 weeks, the change in left ventricular mass index did not differ between treatment groups (paricalcitol group, 0.34 g/m2.7 [95% CI, −0.14 to 0.83 g/m2.7] vs placebo group, −0.07 g/m2.7 [95% CI, −0.55 to 0.42 g/m2.7]). Doppler measures of diastolic function including peak early diastolic lateral mitral annular tissue velocity (paricalcitol group, −0.01 cm/s [95% CI, −0.63 to 0.60 cm/s] vs placebo group, −0.30 cm/s [95% CI, −0.93 to 0.34 cm/s]) also did not differ. Episodes of hypercalcemia were more frequent in the paricalcitol group compared with the placebo group.Conclusion 
                  Forty-eight week therapy with paricalcitol did not alter left ventricular mass index or improve certain measures of diastolic dysfunction in patients with chronic kidney disease.Trial Registration 
                  clinicaltrials.gov Identifier: NCT00497146
SN  - 0098-7484
M3  - doi: 10.1001/jama.2012.120
UR  - http://dx.doi.org/10.1001/jama.2012.120
ER  -