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NDT Plus Advance Access published online on March 24, 2009
NDT Plus, doi:10.1093/ndtplus/sfp034
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The use of vitamin D analogues in chronic kidney diseases: possible mechanisms beyond bone and mineral metabolism

Cheuk-Chun Szeto and Philip Kam-Tao Li

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China

Correspondence: Cheuk-Chun Szeto; E-mail: ccszeto{at}cuhk.edu.hk


  Abstract

Chronic kidney disease (CKD) is a common and costly medical condition, and currently available therapeutic options remain unsatisfactory. Vitamin D analogues are widely used for the bone and mineral disorder associated with CKD. However, accumulating evidence suggests that vitamin D analogues may have actions other than their effects on bone and mineral metabolism. In this article, we review the following aspects on the use of vitamin D analogues for the treatment of CKD: (1) epidemiological studies showing that patients with late-stage CKD have better survival than untreated patients; (2) animal studies showing that vitamin D analogues may retard the progression of CKD; (3) human studies on the anti-proteinuric and possibly renal protecting effects of vitamin D analogues in CKD and (4) the potential mechanisms of its therapeutic benefit. Nonetheless, definitive proof of the clinical benefits by randomized control trial would be necessary before one could advocate the routine use of vitamin D analogues for the treatment of CKD patients.

Key Words: calcitriol • cardiovascular disease • paricalcitol • proteinuria • renal failure

Received for publication January 10, 2009. Accepted for publication March 3, 2009.


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