Pediatric Nephrology

, Volume 20, Issue 3, pp 393–398

Are new vitamin D analogues in renal bone disease superior to calcitriol?

Review

DOI: 10.1007/s00467-004-1788-2

Cite this article as:
Salusky, I.B. Pediatr Nephrol (2005) 20: 393. doi:10.1007/s00467-004-1788-2

Abstract

Progression of chronic kidney disease is associated with an early reduction in serum calcitriol levels; thus, therapy with calcitriol should be initiated early in the course of chronic kidney disease to prevent the development of secondary hyperparathyroidism. Initial studies demonstrated a potential role of calcitriol in the prevention of growth retardation in children with chronic kidney disease prior to dialysis. But the optimal parathyroid hormone (PTH) levels that will maximize growth response during calcitriol treatment remain to be defined. Therapy with calcitriol has been shown to control the biochemical and skeletal manifestations of secondary hyperparathyroidism, but patients developed hypercalcemia, hyperphosphatemia and adynamic osteodystrophy. Thus, new vitamin D analogues with a lower hypercalcemic response have been developed. Although comparative studies are lacking, current evidence indicates that these new active vitamin D sterols (19-nor-paracalcitol and doxercalciferol) adequately control secondary hyperparathyroidism with minimal changes in serum calcium and phosphorus levels during treatment with calcium-containing binders. The long-term effect of such therapies on the skeleton and the process of vascular calcifications remain to be evaluated.

Keywords

Active vitamin D sterols Calcitriol Doxercalciferol Paracalcitol Secondary hyperparathyroidism Chronic kidney disease Children 

Copyright information

© IPNA 2005

Authors and Affiliations

  1. 1.Department of Pediatrics, Division of Pediatric NephrologyDavid Geffen School of Medicine at UCLALos AngelesUSA

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