1-a-Hydroxyvitamin D3 in Chronic Renal Failure
A Potent Analogue of the Kidney Hormone, 1,25-Dihydroxycholecalciferol
- James C. M. Chan, MD;
- Susan B. Oldham, PhD;
- Michael F. Holick, PhD;
- Hector F. DeLuca, PhD
- From the Department of Nephrology, Children's Hospital National Medical Center, and the Department of Child Health and Development, George Washington University School of Medicine, Washington, DC (Dr. Chan); the Children's Hospital of Los Angeles, and the Department of Medicine and Pediatrics, University of Southern California School of Medicine, Los Angeles (Drs. Chan and Oldham); and the Department of Biochemistry, College of Agricultural and Life Sciences, University of Wisconsin, Madison (Drs. Holick and DeLuca).
Abstract
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-α-hydroxyvitamin D3 (1-α-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 1μg to 4μg/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-α-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-α-OH-D3 holds considerable promise for the prevention and treatment of renal osteodystrophy.
(JAMA 234:47-52, 1975)
Footnotes
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Read in part before the 44th annual meeting of the Society for Pediatric Research, Washington, DC, May 3, 1974; the Third International Symposium of Pediatric Nephrology, Washington, DC, Oct 1, 1974; and the 14th International Congress of Pediatrics, Buenos Aires, Oct 5, 1974.
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Reprint requests to Department of Nephrology, Children's Hospital National Medical Center, 2125 Thirteenth St NW, Washington, DC 20009 (Dr. Chan).
