Abstract
Background: The risk of cardiovascular disease is tremendously high in dialysis patients. Dialysis patients treated with vitamin D analogs show decreased cardiovascular morbidity and mortality compared with untreated patients. We examined the influence of two common vitamin D analogs, alfacalcidol and paricalcitol, on important cardiovascular biomarkers in hemodialysis patients. Anti-inflammatory effects and the influence on regulators of vascular calcification as well as markers of heart failure were examined.
Methods. In 57 chronic hemodialysis patients enrolled in a randomized crossover trial comparing paricalcitol and alfacalcidol, we examined the changes in osteoprotegerin, fetuin-A, NT-proBNP, hs-Crp, IL-6 and TNF-, during 16 weeks of treatment.
Results: NT-proBNP and osteoprotegerin increased comparably in the paricalcitol and alfacalcidol-treated groups. Fetuin-A increased significantly in the alfacalcidol-treated group compared with the paricalcitol-treated group (difference 32.84 μmol/l (95% C.I.; range 0.21-67.47)) during the first treatment period. No difference was found between the groups during the second treatment period, and IL-6, TNF- and hs-Crp were unchanged in both treatment groups.
Conclusions: Paricalcitol and alfacalcidol modulate regulators of vascular calcification. Alfacalcidol may increase the level of the calcification inhibitor fetuin-A. We did not find any anti-inflammatory effect or difference in changes of NT-proBNP. Trial registry. ClinicalTrials.gov NCT00469599 May 3 2007.
| Original language | English |
|---|---|
| Article number | 130 |
| Journal | B M C Nephrology |
| Volume | 15 |
| Number of pages | 11 |
| ISSN | 1471-2369 |
| DOIs | |
| Publication status | Published - 12 Aug 2014 |
Keywords
- Aged
- Aged, 80 and over
- Biological Markers
- Calcinosis
- Cross-Over Studies
- Ergocalciferols
- Female
- Humans
- Hydroxycholecalciferols
- Inflammation Mediators
- Male
- Middle Aged
- Natriuretic Peptide, Brain
- Peptide Fragments
- Renal Dialysis
- Vitamin D
