TY  - JOUR
T1  - VItamin d therapy and cardiac function in chronic kidney disease—reply
AU  - Thadhani R, Tamez H, Solomon SD
Y1  - 2012/06/06
N1  - 10.1001/jama.2012.4176
JO  - JAMA
SP  - 2253
EP  - 2253
VL  - 307
IS  - 21
N2  - 
In Reply: Dr Fourtounas and Drs Rajagopalan and Chan highlight the challenge of identifying the most accurate population for a clinical trial. The PRIMO study aimed to evaluate the effect of activated vitamin D analogs in patients otherwise receiving standard of care therapy in 11 different countries worldwide. Therefore, patients who were well treated according to standard clinical practices, which included use of RAAS inhibitors and other blood pressure agents, were enrolled. While these agents themselves may influence left ventricular hypertrophy,1- 2 the conduct of a clinical trial performed on a background of less than standard-of-care therapy would have been unethical, and a positive result from such a trial would have been difficult to interpret. Although paricalcitol did not have an effect on LVMI in patients receiving state-of-the-art care, there was a suggested benefit in other parameters, including cardiovascular hospitalizations, levels of brain natriuretic peptide, and left atrial volume index.

SN  - 0098-7484
M3  - doi: 10.1001/jama.2012.4176
UR  - http://dx.doi.org/10.1001/jama.2012.4176
ER  -