IS 1,25‐DIHYDROXY‐CHOLECALCIFEROL HARMFUL TO RENAL FUNCTION IN PATIENTS WITH CHRONIC RENAL FAILURE?

Abstract

Seventeen undialyzed adult patients with chronic renal failure took part in a controlled study of the effects of 1,25(OH)2D3 and vitamin D3. After a 6-mo. observation period the patients were allocated at random to 2 groups for 6 mo. of treatment with either 1,25(OH)2D3 (mean dose 0.5 .mu.g daily) or D3 (dose 100 .mu.g daily). Treatment was then discontinued and the patients were studied for a further 6 mo. Serum iPTH [immunoreactive parathyroid hormone] was decreased in both groups but most markedly in the 1,25(OH)2D3 group in which the iPTH values became normal. Serum creatinine increased during treatment in both groups. In the group receiving 1,25(OH)2D3 this was coupled to an increase in serum Ca within the normal range. 1,25(OH)2D3 treatment in patients with chronic renal failure leads to a further reduction in renal function, which may be partially reversible. Physicians should therefore be reluctant to give vitamin D analogs to patients with chronic renal failure unless they have severe symptomatic renal osteodystrophy.