Meta-analysis: the Efficacy and Safety of Paricalcitol for the Treatment of Secondary Hyperparathyroidism and Proteinuria in Chronic Kidney Disease

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2013 Mar 20

PMID 23509710

Citations 17

Authors

Tianzhao Han

Gong Rong

Dayong Quan

Ying Shu

Zhu Liang

Ninglan She

Manli Liu

Bing Yang

Gong Cheng

Yongman Lv

Leonard Stern

Affiliations

Soon will be listed here.

Abstract

Introduction: Previous studies have demonstrated the safety and efficacy of using Paricalcitol for the treatment of secondary hyperparathyroidism (SHPT) in patients on dialysis. The aim of the current meta-analysis was to assess the safety and efficacy of Paricalcitol for the management of SHPT in patients with chronic kidney disease (CKD) not yet on dialysis. A secondary aim was to determine if sufficient data was available to assess the effect of Paricalcitol for the management of proteinuria.

Methods: A meta-analysis was conducted using the Cochrane Collaboration's RevMan 4.2 software.

Results: Paricalcitol is effective in lowering PTH in patients with CKD not yet on dialysis and is also effective in lowering proteinuria in diabetic CKD patients. However, we uncovered a safety signal identifying an elevated calcium phosphate product and a trend towards the development of hypercalcemia. A phosphate elevation was not demonstrated because the target used in the clinical studies was a P > 5.5 mg/dl, a value appropriate for dialysis patients and not CKD patients.

Conclusion: Although Paricalcitol is effective in lowering PTH, we advise caution in the use of any active Vitamin D analogues in patients with CKD because of the potential risk of exacerbating vascular calcification.

Citing Articles

Paricalcitol and Extended-Release Calcifediol for Treatment of Secondary Hyperparathyroidism in Non-Dialysis Chronic Kidney Disease: Results From a Network Meta-Analysis.

Franchi M, Gunnarsson J, Gonzales-Parra E, Ferreira A, Strom O, Corrao G J Clin Endocrinol Metab. 2023; 108(11):e1424-e1432.

PMID: 37235771 PMC: 10583991. DOI: 10.1210/clinem/dgad289.

A comparative analysis of the efficacy and safety of paricalcitol versus other vitamin D receptor activators in patients undergoing hemodialysis: A systematic review and meta-analysis of 15 randomized controlled trials.

Geng X, Shi E, Wang S, Song Y PLoS One. 2020; 15(5):e0233705.

PMID: 32470067 PMC: 7259607. DOI: 10.1371/journal.pone.0233705.

Efficacy and safety of cinacalcet and active vitamin D in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease: a network meta-analysis.

Ni L, Yuan C, Song K, Wang X, Chen S, Wang L Ann Transl Med. 2019; 7(14):322.

PMID: 31475192 PMC: 6694249. DOI: 10.21037/atm.2019.05.84.

Changes in microparticle profiles by vitamin D receptor activation in chronic kidney disease - a randomized trial.

Lundwall K, Mortberg J, Mobarrez F, Jacobson S, Jorneskog G, Spaak J BMC Nephrol. 2019; 20(1):290.

PMID: 31370809 PMC: 6670162. DOI: 10.1186/s12882-019-1445-4.

NUTRITIONAL OR ACTIVE VITAMIN D FOR THE CORRECTION OF MINERAL METABOLISM ABNORMALITIES IN NON-DIALYSIS CHRONIC KIDNEY DISEASE PATIENTS?.

Stancu S, Chiriac C, Maria D, Mota E, Mircescu G, Capusa C Acta Endocrinol (Buchar). 2019; 14(4):505-513.

PMID: 31149304 PMC: 6516423. DOI: 10.4183/aeb.2018.505.

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