Paricalcitol reduces albuminuria and inflammation in chronic kidney disease a randomized double-blind pilot trial

Pooneh Alborzi, Nina A. Patel, Carla Peterson, Jennifer E. Bills, Dagim M. Bekele, Zerihun Bunaye, Robert P. Light, Rajiv Agarwal

Research output: Contribution to journalArticle

280 Scopus citations

Abstract

Vitamin D receptor activation is associated with improved survival in patients with chronic kidney disease, but the mechanism of this benefit is unclear. To better understand the effects of vitamin D on endothelial function, blood pressure, albuminuria, and inflammation in patients with chronic kidney disease (2 patients stage 2, remaining stage 3), we conducted a pilot trial in 24 patients who were randomly allocated equally to 3 groups to receive 0, 1, or 2 μg of paricalcitol, a vitamin D analog, orally for 1 month. Placebo-corrected change in flow mediated dilatation with a 1-μg dose was 0.5% and 0.4% with a 2-μg dose (P>0.2). At 1 month, the treatment:baseline ratio of high sensitivity C-reactive protein was 1.5 (95% CI: 1.1 to 2.1; P=0.02) with placebo, 0.8 (95% CI: 0.3 to 1.9; P=0.62) with a 1-μg dose, and 0.5 (95% CI: 0.3 to 0.9; P=0.03) with a 2-μg dose of paricalcitol. At 1 month, the treatment:baseline ratio of 24-hour albumin excretion rate was 1.35 (95% CI: 1.08 to 1.69; P=0.01) with placebo, 0.52 (95% CI: 0.40 to 0.69; P<0.001) with a 1-μg dose, and 0.54 (95% CI: 0.35 to 0.83; P=0.01) with a 2-μg dose (P<0.001 for between group changes). No differences were observed in iothalamate clearance, 24-hour ambulatory blood pressure, or parathyroid hormone with treatment or on washout. Thus, paricalcitol-induced reduction in albuminuria and inflammation may be mediated independent of its effects on hemodynamics or parathyroid hormone suppression. Long-term randomized, controlled trials are required to confirm these benefits of vitamin D analogs.

Original languageEnglish (US)
Pages (from-to)249-255
Number of pages7
JournalHypertension
Volume52
Issue number2
DOIs
StatePublished - Aug 1 2008

Keywords

  • Albuminuria
  • Ambulatory blood pressure
  • Chronic kidney disease
  • Endothelial function
  • Inflammation
  • Vitamin d

ASJC Scopus subject areas

  • Internal Medicine

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