Review Article

Vitamin D Receptor Activators and Clinical Outcomes in Chronic Kidney Disease

Table 8

Cardiovascular protection.

AuthorYearStudyOutcome

Bodyak et al. [37]2007Study in Dahl salt-sensitive (DSS) rats to evaluate if paricalcitol is able to attenuate the development of left ventricular abnormalitiesCompared with DSS rats fed a high-salt (HS) diet (6% NaCl for 6 weeks), DSS rats fed a high-salt HS receiving paricalcitol showed lower heart and lung weights, reduced LV mass, posterior wall thickness and end diastolic pressures, and increased fractional shortening. Blood pressures did not significantly differ between the groups

Xiang et al. [38]2005VDR knockout (KO) mice were compared with wild-type (WT) miceIn VDRKO mice, the cardiac renin mRNA level was significantly increased, suggesting that the cardiac hypertrophy in VDRKO mice is a consequence of activation of both the systemic and cardiac RAS and that 1,25-dihydroxyvitamin D3 regulates cardiac functions

Zhou et al. [39]200825(OH)D 1alpha-hydroxylase KO mice were compared with WT mice to determine whether the cardiovascular effect of 1,25vitD is dependent on calcium or phosphorus.Ablation of the 1alpha-hydroxylase gene in mice led to hypertension, cardiac hypertrophy, and systolic dysfunction, and this cardiac phenotype was rescued with exogenous 1,25vitD administration. 1,25vitD plays a protective role in the cardiovascular system by repressing the renin-angiotensin system independent of extracellular calcium or phosphorus.

PRIMO study (Paricalcitol Benefits in Renal Disease Induced Cardiac Morbidity Study) [40]OngoingRCT, oral paricalcitol compared to placebo in 220 predialysis patients (GFR 15–45 ml/min) affected by mild-to-moderate LVH and an LV ejection fraction >50%Study ongoing

Mizobuchi et al. [41]2007Uremic rats (5/6 NX rats) were given calcitriol, paricalcitol, or doxercalciferol 3/week for 1 monthCalcitriol and doxercalciferol, but not paricalcitol, increased vascular calcification in uremic rats. The different effects of VDRA on vascular calcification are independent of an effect on Ca and P. Doxercalciferol significantly increased the Ca × P product and the aortic calcium content. A lower doxercalciferol did not increase the calcium-phosphate product but increased the aortic calcium content.