1,25(OH)2D3 administration in moderate renal failure: A prospective double-blind trial

L. R I Baker, S. M L Abrams, C. J. Roe, M. C. Faugere, P. Fanti, Y. Subayti, H. H. Malluche

Research output: Contribution to journalArticle

155 Citations (Scopus)

Abstract

This study represents the first randomized prospective, double-blind, placebo-controlled trial of the efficacy of 1,25(OH)2D3 on bone histology and serum biochemistry in patients with mild to moderate renal failure. Sixteen patients with chronic renal impairment (creatinine clearance 20 to 59 ml per min) received either 1,25(OH)2D3, at a dose of 0.25 to 0.5 μg daily (8 patients), or placebo. Transiliac crest bone biopsies were performed before entrance into the study and after 12 months of experimental observation. None of the patients were symptomatic or had radiological evidence of bone disease. Of the 13 patients who completed the study, initial serum 1,25(OH)2D levels were low in 7 patients and parathyroid hormone levels were elevated in 7 patients. Bone histology was abnormal in all patients. 1,25(OH)2D3 treatment was associated with a significant fall in serum phosphorus and alkaline phosphatase concentrations as well as with histological evidence of an amelioration of hyperparathyroid changes. In contrast to previous reports, no deterioration of renal function attributable to the treatment occurred, perhaps because a modest dose of 1,25(OH)2D3 was employed combined with meticulous monitoring. Further investigation is required to determine whether alternative therapeutic strategies (smaller doses or intermittent therapy) may avoid the potential for suppressing bone turnover to abnormally low levels in the long term.

Original languageEnglish (US)
Pages (from-to)661-669
Number of pages9
JournalKidney International
Volume35
Issue number2
StatePublished - 1989
Externally publishedYes

Fingerprint

Renal Insufficiency
Bone and Bones
Histology
Serum
Placebos
Kidney
Bone Remodeling
Bone Diseases
Therapeutics
Parathyroid Hormone
Biochemistry
Phosphorus
Alkaline Phosphatase
Creatinine
Observation
Biopsy

ASJC Scopus subject areas

  • Nephrology

Cite this

Baker, L. R. I., Abrams, S. M. L., Roe, C. J., Faugere, M. C., Fanti, P., Subayti, Y., & Malluche, H. H. (1989). 1,25(OH)2D3 administration in moderate renal failure: A prospective double-blind trial. Kidney International, 35(2), 661-669.

1,25(OH)2D3 administration in moderate renal failure : A prospective double-blind trial. / Baker, L. R I; Abrams, S. M L; Roe, C. J.; Faugere, M. C.; Fanti, P.; Subayti, Y.; Malluche, H. H.

In: Kidney International, Vol. 35, No. 2, 1989, p. 661-669.

Research output: Contribution to journalArticle

Baker, LRI, Abrams, SML, Roe, CJ, Faugere, MC, Fanti, P, Subayti, Y & Malluche, HH 1989, '1,25(OH)2D3 administration in moderate renal failure: A prospective double-blind trial', Kidney International, vol. 35, no. 2, pp. 661-669.
Baker LRI, Abrams SML, Roe CJ, Faugere MC, Fanti P, Subayti Y et al. 1,25(OH)2D3 administration in moderate renal failure: A prospective double-blind trial. Kidney International. 1989;35(2):661-669.
Baker, L. R I ; Abrams, S. M L ; Roe, C. J. ; Faugere, M. C. ; Fanti, P. ; Subayti, Y. ; Malluche, H. H. / 1,25(OH)2D3 administration in moderate renal failure : A prospective double-blind trial. In: Kidney International. 1989 ; Vol. 35, No. 2. pp. 661-669.
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