scholarly journals Effect of High Dose Active Vitamin D Therapy on the Development of Hypocalcemia After Subtotal Parathyroidectomy in Patients on Chronic Dialysis

2021 ◽  
Vol Volume 14 ◽  
pp. 399-410
Author(s):  
Malina Grube ◽  
Frank Weber ◽  
Anna Lena Kahl ◽  
Andreas Kribben ◽  
Nils Mülling ◽  
...  
Keyword(s):  
Vitamin D ◽  
Chronic Dialysis ◽  
High Dose ◽  
Active Vitamin ◽  
Subtotal Parathyroidectomy ◽  
Active Vitamin D

MO944BONE DISEASE AFTER KIDNEY TRANSPLANTATION - (SUBTOTAL) PARATHYROIDECTOMY REDUCES FRACTURE RISK

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ulrich Jehn ◽  
Anja Kortenhorn ◽  
Katharina Schütte-Nütgen ◽  
Markus Strauss ◽  
Hermann Josef Pavenstädt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Fracture Risk ◽  
Protective Factor ◽  
Active Vitamin ◽  
Pathological Fractures ◽  
Subtotal Parathyroidectomy ◽  
Active Vitamin D ◽  
Mineral Bone Disorder ◽  
Bone Disorder

Abstract Background and Aims Kidney transplant recipients can be considered as high-risk collective for pathological fractures, since diverse risk factors leading to mineral bone disorder (MBD) and osteoporosis accumulate in this setting. (Subtotal) parathyroidectomy (PTX) is indicated for ESRD patients with secondary hyperparathyroidism (sHPT) who do not respond to drug therapy adequately. This study aims to identify influencable factors that are associated with pathological fractures and bone disease in KTX recipients. Method We conducted a retrospective study involving 722 adult patients with a total of 4686 patient-years who were transplanted at our center between January 2007 and June 2015. The clinical patient data was extracted from the patients’ electronic files. Different laboratory and clinical parameters for mineral bone disorder and osteoporosis including medication were evaluated. As primary endpoint we chose fracture events that were not related to malignancies or adequate trauma. Results 47 (6,5%) of the patients suffered from pathologic fracture events during the follow-up period. 124 of the patients (17.2%) underwent PTX. In 112 of these patients (90.3%), PTX was performed prior to kidney transplantation (KTx), in 12 patients PTX took place after KTx. Median time for PTX in relation to KTx was 3.7 years prior to KTx (IQR 5.43). Only 1 (2,2%) of the patients with fracture events has received PTX beforehand compared to 124 (19,2%) of the patients without fractures. Adjusted for the well-known fracture risk factors for mineral bone disease and osteoporosis which include female sex, age and dialysis vintage, PTX remains a significant protective factor against fractures after KTx in multivariable Cox regression analysis (HR 0.124, p=0.041) and in Kaplan-Meier analysis (Figure 1). Serum calcium levels were significantly lower in patients after PTX (p<0.001). Active Vitamin D was applicated in patients after PTX more frequently (40.0% vs. 22.7%, p<0.001) Conclusion Our study reveals PTX as a protective factor regarding pathological fractures after KTx. As these patients show lower serum calcium levels, one explanation for this finding could be a more generous supplementation of these patients with active vitamin D, which is known to increase bone mineral density and to reduce fracture risk. Therefore, considering that hypoprathyroidism following PTX after KTx and low plasma-PTH levels correlate with significant decrease of renal function, patients on conservative sHPT therapy should be treated with active vitamin D preparations more generously and special attention should be paid on bone metabolism.

Treatment with active vitamin D (alphacalcidol) in patients with mild primary hyperparathyroidism

1989 ◽  
Vol 120 (2) ◽  
pp. 250-256 ◽  
Author(s):  
Lars Lind ◽  
Bo Wengle ◽  
Ole Helmer Sørensen ◽  
Leif Wide ◽  
Göran Åkerström ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Controlled Study ◽  
High Dose ◽  
Active Vitamin ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D ◽  
Active Vitamin D ◽  
Mild Primary Hyperparathyroidism

Abstract. The parathyroid gland possesses receptors for 1,25-dihydroxyvitamin D3, the active metabolite of the vitamin D system, and in vitro experiments have shown that 1,25-dihydroxyvitamin D3 can inhibit the secretion of PTH. In this study 31 subjects who had displayed persistent mild hypercalcemia for 14 years and presumably had mild primary hyperparathyroidism (HPT) were challenged with 1.0 μg alphacalcidol (1α-(OH)-vitamin D3) over 6 months in a double-blind, placebo-controlled study. Before initiation of therapy, the hyperparathyroid subjects showed lower serum levels of 1,25-dihydroxyvitamin D in relation to PTH or calcium when compared with age- and sex-matched controls. Treatment induced a slight rise in serum calcium (0.05 mmol/l), but no significant decrease of the PTH levels. Eighteen of the subjects thereafter entered an open study with a higher dose of alphacalcidol (2.0 μg) over 1 year. Although this high dose induced a marked rise in serum calcium (0.17 mmol/l), there was only a transient reduction of the PTH levels. Thus, during long-term condition there was an escape from the suppressive action of the elevated calcium concentrations and no evidence of a specific inhibition of PTH secretion by a small oral dose of active vitamin D.

scholarly journals Active vitamin D supplementation and COVID-19 infections: review

2021 ◽  
Author(s):  
Nakhoul Farid ◽  
Nakhoul Rola ◽  
Elias A. T. Koch ◽  
Nakhoul Nakhoul
Keyword(s):  
Vitamin D ◽  
Vitamin D Supplementation ◽  
Active Vitamin ◽  
Active Vitamin D

Design and synthesis of active vitamin D analogs

2010 ◽  
Vol 121 (1-2) ◽  
pp. 7-12 ◽  
Author(s):  
Silvina Eduardo-Canosa ◽  
Ramón Fraga ◽  
Rita Sigüeiro ◽  
Maria Marco ◽  
Natacha Rochel ◽  
...  
Keyword(s):  
Vitamin D ◽  
Active Vitamin ◽  
Vitamin D Analogs ◽  
Design And Synthesis ◽  
Active Vitamin D

scholarly journals Vitamin D and Serum Cytokines in a Randomized Clinical Trial

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Eleanor Yusupov ◽  
Melissa Li-Ng ◽  
Simcha Pollack ◽  
James K. Yeh ◽  
Mageda Mikhail ◽  
...  
Keyword(s):  
Vitamin D ◽  
Placebo Group ◽  
Vitamin D3 ◽  
Intracellular Signaling ◽  
Final Visit ◽  
Active Vitamin ◽  
Gm Csf ◽  
Active Vitamin D ◽  
Significant Difference ◽  
Vitamin D3 Supplementation

Background. The role of vitamin D in the body's ability to fight influenza and URI's may be dependent on regulation of specific cytokines that participate in the host inflammatory response. The aim of this study was to test the hypothesis that vitamin D can influence intracellular signaling to regulate the production of cytokines.Subjects and Methods. This study was a 3-month prospective placebo-controlled trial of vitamin D3 supplementation in ambulatory adults [Li-Ng et al., 2009]. 162 volunteers were randomized to receive either 50 μg/d(2000 IU) of vitamin D3 or matching placebo. 25(OH)D and the levels of 10 different cytokines (IL-2, 4, 5, 6, 8, 10, 13, GM-CSF, IFN-γ, TNF-α) were measured in the serum of participants at baseline and the final visit. There were 6 drop-outs from the active vitamin D group and 8 from the placebo group.Results. In the active vitamin D group, we found a significant median percent decline in levels of GM-CSF (−62.9%,P<.0001), IFN-γ(−38.9%,P<.0001), IL-4 (−50.8%,P=.001), IL-8 (−48.4%,P<.0001), and IL-10 (−70.4%,P<.0001). In the placebo group, there were significant declines for GM-CSF (−53.2%,P=.0007) and IFN-γ(−34.4%,P=.0011). For each cytokine, there was no significant difference in the rate of decline between the two groups. 25(OH)D levels increased in the active vitamin D group from a mean of64.3±25.4 nmol/L to88.5±23.2 nmol/L.Conclusions. The present study did not show that vitamin D3 supplementation changed circulating cytokine levels among healthy adults.

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