1-alpha-hydroxyvitamin D3 in chronic renal failure. A potent analogue of the kidney hormone, 1,25-dihydroxycholecalciferol
J. C. Chan, S. B. Oldham, M. F. Holick and H. F. DeLuca
In chronic renal disease, the synthesis of the kidney hormone,
1,25-dihydroxyvitamin D3 (1,25-(OH)2D3), is impaired, thus contributing to
the development of renal osteodystrophy. The clinical use of 1,25-(OH)2D3
is limited, due to the complexity and expense of its chemical synthesis.
This study reports the use of 1-alpha-hydroxyvitamin D3 (1-alpha-OH-D3), an
active analogue of 1,25-(OH)2D3, in eight patients with chronic renal
failure, five of whom were undergoing long-term hemodialysis. The drug was
given orally for 6 to 260 days at a dosage of 1mug to 4mug/day. Short-term
(21 days) balance studies showed an increase in intestinal calcium
absorption and a simultaneous fall in serum parathyroid hormone levels
during administration of 1-alpha-OH-D3. In two long-term studies (160 and
260 days), roentgenographic improvement of renal osteodystrophy was seen
after 45 and 185 days, respectively. The data indicate that 1-alpha-OH-D3
holds considerable promise for the prevention and treatment of renal
osteodystrophy.
