IMPACT OF PARICALCITROL ON INFLAMMATORY AND ANAEMIA MARKERS IN DIALYSIS PATIENTS
Background: The role of Vitamin D in calcium and phosphate homeostasis is renowned. The effects of vitamin D on bone metabolism have been established for long. We planned to see the effects of vitamin D analogue paricalcitrol as on mineral bone disorder in chronic kidney disease. (CKD MBD) parameters and markers of anaemia and inflammation. Method: This prospective and observational study was done at King Fahd Hospital, Medina, Saudi Arabia for 3 months from Jan to Apr 2017. Two hundred and ten (210) patients fulfilled the eligibility criteria. Paricalcitrol was given at a dose of 0.04 μg/Kg 3 times a week and parathyroid (PTH) was monitored for 3 months and subsequently the dose was titrated to the PTH levels. We looked at the relationship between paricalcitrol and anaemia markers, inflammatory markers, and erythropoietic stimulating agent dose. Results: Two hundred and ten (210) patients were studied, mean age was 50 years, 55% were males; 120 were excluded who had vitamin D level in the normal range, who received vitamin D in the recent past, with phosphate levels >2 and calcium levels >2.55 mmol/L, on calcimimmetics, parathyroidectomy cases, and patients with active infection or malignancy. Parathyroid hormone (PTH) fell significantly -166.4 (95% CI -290, -42.5, p<0.05), Transferrin saturation improved significantly (4.4% 95% CI 1.6, 7.2 p=0.003). CRP fell significantly (p<0.01). However, Hb or ESA requirement did not reach statistical significance. Conclusion: Paricalcitrol treatment is associated with improvement in secondary hyperparathyroidism in haemodialysis population. There is a signal towards improvement in markers of inflammation and anaemia but a larger Randomised Control Trial (RCT) is needed to be done.
Pak J Physiol 2018;14(2):3–6
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