Loading...
Publication
Benefits of Selective Vitamin D Receptor Activators in Kidney Transplanted Patients
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 808.71 KB | Adobe PDF |
Advisor(s)
Abstract(s)
Severe chronic kidney disease may lead to disturbances, such as hyperphosphatemia, increased secretion
of fibroblast growth factor -23 (FGF -23) and vitamin D deficiency. These may increase plasmatic levels of
parathyroid hormone, and decrease plasmatic levels of calcium. Altogether, these may contribute to the
development of secondary hyperparathyroidism, and to abnormalities in mineral metabolism. Kidney transplantation is the best option to improve longevity and quality of life in end -stage chronic kidney disease
patients. Vitamin D deficiency has been associated with cardiovascular disease, which is the leading cause
of death in chronic kidney disease. Therefore, diagnosing this deficiency may be pivotal for minimizing
mortality in chronic kidney disease, because pharmacological treatments for this deficiency may be prescribed.
Calcitriol is indicated for the treatment of vitamin D deficiency, both in chronic kidney disease and
in kidney transplanted patients. However, calcitriol may increase the plasmatic levels of calcium and phosphorous, which can lead to vascular calcifications, that have been associated with cardiovascular mortality.
Selective vitamin D receptor activators are indicated for the treatment of vitamin D deficiency in chronic
kidney disease. These have the advantage of being associated with lower increases of plasmatic levels of
calcium and phosphorous. These drugs also seem to have additional effects that may minimise patient
morbidity and mortality, especially due to potentially reducing cardiovascular events. Unfortunately, there
are few studies about the use of these drugs in kidney transplanted patients. Here we present a review about the physiology of vitamin D, the consequences of its deficiency in chronic kidney disease and in
kidney transplanted patients, and about the diagnosis and treatment of this deficiency. Finally, we discuss
the new line of research about the efficacy and safety of selective vitamin D receptor activators in kidney
transplanted patients.
Description
Keywords
HCC NEF Calcitriol Cholecalciferol Paricalcitol Kidney Failure, Chronic Review Vitamin D
Citation
Port J Nephrol Hypert 2015; 29 (3): 194-206