Effect of vitamin D sterols on bone histology in pre-dialysis patients: A prospective controlled study

Data de publicação:

Autores da FMUP

  • Ricardo Morais Pereira Neto

    Autor

  • Janete Maria Quelhas Dos Santos

    Autor

  • João Miguel Machado Dória Frazão

    Autor

Participantes de fora da FMUP

  • Pereira, L
  • Magalhaes, J

Unidades de investigação

Abstract

Background: Abnormalities related to mineral and bone metabolism are a common finding in chronic kidney disease (CKD). Vitamin D compounds are often prescribed to CKD patients with the purpose to control secondary hyperparathyroidism and reduce the risk of high-turnover bone disease. However, data on the effect of vitamin D sterols on bone histology in non-dialysis CKD is limited. Materials and methods: A prospective controlled study was conducted on a cohort of 56 patients with CKD stages 3 and 4. 19 patients on calcitriol and 12 patients on cholecalciferol were compared to a group of 25 age-and sex-matched controls. Participants underwent a tetracycline double-labelled transiliac bone biopsy before starting therapy and again 12 months later. Changes from baseline in circulating biomarkers and bone histomorphometric parameters were analyzed. Results: Low turnover bone disease was the most common pattern of renal osteodystrophy on the initial biopsy. There was no difference in biochemical or histomorphometric values between the three study groups at baseline. Serum intact parathormone (iPTH) and bone formation rate decreased significantly in calcitriol-treated patients, with prevalence of low-turnover bone disease doubling from baseline. In contrast, no significant changes were noted in cholecalciferol-treated and control subjects. Conclusion: Calcitriol was effective in preventing secondary hyperparathyroidism and high-turnover bone disease. However, it was associated with an increased risk of developing or aggravating low-turnover bone disease. In the absence of a bone biopsy, calcitriol use in pre-dialysis CKD should be reserved for patients with a progressive rise in iPTH levels, in whom high-turnover bone disease is suspected.

Dados da publicação

ISSN/ISSNe:
0301-0430,

Clinical Nephrology  Dustri-Verlag Dr. Karl Feistle

Tipo:
Article
Páginas:
17-25
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 1

Citações Recebidas na Scopus: 1

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Keywords

  • bone biopsy; pre-dialysis patients; bone histomorphometry; cholecalciferol; calcitriol&nbsp

Proyectos asociados

Update on the impact of sodium-glucose cotransporter inhibitors in diabetic kidney disease progression

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Estudo Clínico Académico (Diabetic Kidney) . 2020

Novos Agentes Redutores de Potássio na Abordagem da Hipercalémia na Doença Renal Crónica

Investigador Principal: Ricardo Morais Pereira Neto

Estudo Clínico Académico . 2021

Kidney-induced osteoporosis: a new entity with a novel therapeutic approach.

Investigador Principal: João Miguel Machado Dória Frazão

Estudo Clínico Académico . 2020

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