Meta-analysis: the efficacy and safety of paricalcitol for the treatment of secondary hyperparathyroidism and proteinuria in chronic kidney disease.

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.

journal_name

Biomed Res Int

authors

Han T,Rong G,Quan D,Shu Y,Liang Z,She N,Liu M,Yang B,Cheng G,Lv Y,Stern L

doi

10.1155/2013/320560

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

320560

eissn

2314-6133

issn

2314-6141

journal_volume

2013

pub_type

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