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Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease
Secondary hyperparathyroidism (sHPT) represents the adaptive and very often, finally, maladaptive response of the organism to control the disturbed homeostasis of calcium, phosphorus, and vitamin D metabolism caused by declining renal function in chronic kidney disease (CKD). sHPT leads to cardiovas...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436758/ https://www.ncbi.nlm.nih.gov/pubmed/28546765 http://dx.doi.org/10.2147/IJNRD.S97637 |
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author | Friedl, Claudia Zitt, Emanuel |
author_facet | Friedl, Claudia Zitt, Emanuel |
author_sort | Friedl, Claudia |
collection | PubMed |
description | Secondary hyperparathyroidism (sHPT) represents the adaptive and very often, finally, maladaptive response of the organism to control the disturbed homeostasis of calcium, phosphorus, and vitamin D metabolism caused by declining renal function in chronic kidney disease (CKD). sHPT leads to cardiovascular and extravascular calcifications and is directly linked to an increased risk of cardiovascular morbidity and mortality as well as excess all-cause mortality. Vitamin D plays an important role in the development of sHPT. CKD patients are characterized by a high prevalence of hypovitaminosis D. Supplementation with both vitamin D prohormones cholecalciferol and ergocalciferol enables the achievement and maintenance of a normal vitamin D status when given in adequate doses over an appropriate treatment period. In patients with earlier stages of CKD, sHPT is influenced by and can be successfully treated with vitamin D prohormone supplementation, whereas in patients with very late stages of CKD and those requiring dialysis, treatment with prohormones seems to be of limited efficacy. This review gives an overview of the pathogenesis of sHPT, summarizes vitamin D metabolism, and discusses the existing literature regarding the role of vitamin D prohormone in the treatment of sHPT in patients with CKD. |
format | Online Article Text |
id | pubmed-5436758 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-54367582017-05-25 Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease Friedl, Claudia Zitt, Emanuel Int J Nephrol Renovasc Dis Review Secondary hyperparathyroidism (sHPT) represents the adaptive and very often, finally, maladaptive response of the organism to control the disturbed homeostasis of calcium, phosphorus, and vitamin D metabolism caused by declining renal function in chronic kidney disease (CKD). sHPT leads to cardiovascular and extravascular calcifications and is directly linked to an increased risk of cardiovascular morbidity and mortality as well as excess all-cause mortality. Vitamin D plays an important role in the development of sHPT. CKD patients are characterized by a high prevalence of hypovitaminosis D. Supplementation with both vitamin D prohormones cholecalciferol and ergocalciferol enables the achievement and maintenance of a normal vitamin D status when given in adequate doses over an appropriate treatment period. In patients with earlier stages of CKD, sHPT is influenced by and can be successfully treated with vitamin D prohormone supplementation, whereas in patients with very late stages of CKD and those requiring dialysis, treatment with prohormones seems to be of limited efficacy. This review gives an overview of the pathogenesis of sHPT, summarizes vitamin D metabolism, and discusses the existing literature regarding the role of vitamin D prohormone in the treatment of sHPT in patients with CKD. Dove Medical Press 2017-05-11 /pmc/articles/PMC5436758/ /pubmed/28546765 http://dx.doi.org/10.2147/IJNRD.S97637 Text en © 2017 Friedl and Zitt. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Review Friedl, Claudia Zitt, Emanuel Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease |
title | Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease |
title_full | Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease |
title_fullStr | Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease |
title_full_unstemmed | Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease |
title_short | Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease |
title_sort | vitamin d prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436758/ https://www.ncbi.nlm.nih.gov/pubmed/28546765 http://dx.doi.org/10.2147/IJNRD.S97637 |
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