Vitamin D Receptor Activators and Clinical Outcomes in Chronic Kidney Disease

Table 10

Renal protection and reduction of proteinuria.

Author	Year	Study	Outcome
Agarwal et al. [43]	2005	Three RCTs in 220 CKD stage 3 and 4 patients randomized to oral paricalcitol (𝑁=107) or placebo (𝑁=113), followed for up to 24 weeks	Decreased proteinuria in 29/57 (51%) of paricalcitol patients versus 15/61 (25%) placebo patients, 𝑃=.004 (odds for reduction in proteinuria 3.2 times greater for paricalcitol patients)
de Zeeuw et al. (VITAL study) [44]	2010	Multinational RCT in 281 patients with type 2 diabetes and albuminuria receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were randomized to receive 24-week treatment with placebo, 1 μg/day paricalcitol, or 2 μg/day paricalcitol	Patients on 2 μg paricalcitol had an early, sustained reduction in UACR (urinary albumin-to-creatinine ratio), ranging from –18% to −28% (𝑃=.014) versus placebo
Fishbane et al. [45]	2009	RCT of 61 patients with estimated glomerular filtration rate from 15 to 90 mL/min/1.73 m^2 and protein excretion greater than 400 mg/24 h to receive paricalcitol, 1 mcg/day, or placebo.	Changes in protein excretion from baseline to last evaluation were +2.9% for controls and −17.6% for the paricalcitol group (𝑃<.05).
Zhang et al. [46]	2008	Study in streptozotocin- (STZ-) induced diabetes model mice	Treatment with losartan and paricalcitol completely prevented albuminuria, restored glomerular filtration barrier structure, and markedly reduced glomerulosclerosis, effectively preventing renal injury in diabetic nephropathy