scholarly journals Mortality in Hemodialysis Patients with COVID-19, the Effect of Paricalcitol or Calcimimetics

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2559
Author(s):  
María Dolores Arenas Jimenez ◽  
Emilio González-Parra ◽  
Marta Riera ◽  
Abraham Rincón Bello ◽  
Ana López-Herradón ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mortality Rate ◽  
Secondary Hyperparathyroidism ◽  
Cox Regression ◽  
Serum Vitamin ◽  
Hemodialysis Patients ◽  
Active Vitamin ◽  
Cox Regression Analysis ◽  
Active Vitamin D ◽  
The Impact

Background. In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-19 infection. Some hemodialysis patients receive treatment with drugs for secondary hyperparathyroidism, which have well known pleiotropic effects beyond mineral metabolism. The aim of this study was to evaluate the impact of VD status and the administration of active vitamin D medications, used to treat secondary hyperparathyroidism, on survival in a cohort of COVID-19 positive HD patients. Methods. A cross-sectional retrospective observational study was conducted from 12 March to 21 May 2020 in 288 HD patients with positive PCR for SARS-CoV2. Patients were from 52 different centers in Spain. Results. The percent of HD patients with COVID-19 was 6.1% (288 out of 4743). Mortality rate was 28.4% (81/285). Three patients were lost to follow-up. Serum 25(OH)D (calcidiol) level was 17.1 [10.6–27.5] ng/mL and was not significantly associated to mortality (OR 0.99 (0.97–1.01), p = 0.4). Patients receiving active vitamin D medications (16/94 (17%) vs. 65/191(34%), p = 0.003), including calcimimetics (4/49 (8.2%) vs. 77/236 (32.6%), p = 0.001), paricalcitol or calcimimetics (19/117 (16.2%) vs. 62/168 (36.9%); p < 0.001), and also those on both paricalcitol and calcimimetics, to treat secondary hyperparathyroidism (SHPTH) (1/26 (3.8%) vs. 80/259 (30.9%), p < 0.001) showed a lower mortality rate than patients receiving no treatment with either drug. Multivariate Cox regression analysis confirmed this increased survival. Conclusions. Our findings suggest that the use of paricalcitol, calcimimetics or the combination of both, seem to be associated with the improvement of survival in HD patients with COVID-19. No correlation was found between serum VD levels and prognosis or outcomes in HD patients with COVID-19. Prospective studies and clinical trials are needed to support these findings.

scholarly journals The impact of cinacalcet in the mineral metabolism markers of patients on dialysis with severe secondary hyperparathyroidism

2019 ◽  
Vol 41 (3) ◽  
pp. 336-344
Author(s):  
Sérgio Gardano Elias Bucharles ◽  
Fellype Carvalho Barreto ◽  
Miguel Carlos Riella
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Secondary Hyperparathyroidism ◽  
Mineral Metabolism ◽  
Phosphate Binders ◽  
Dialysis Patients ◽  
Active Vitamin ◽  
Ipth Level ◽  
Active Vitamin D ◽  
The Impact

Abstract Introduction: Treating secondary hyperparathyroidism (SHPT), a common condition associated with death in patients with chronic kidney disease, is a challenge for nephrologists. Calcimimetics have allowed the introduction of drug therapies no longer based on phosphate binders and active vitamin D. This study aimed to assess the safety and effectiveness of cinacalcet in managing chronic dialysis patients with severe SHPT. Methods: This retrospective study included 26 patients [age: 52 ± 12 years; 55% females; time on dialysis: 54 (4-236) months] on hemodialysis (N = 18) or peritoneal dialysis (N = 8) with severe SHPT (intact parathyroid hormone (iPTH) level > 600 pg/mL) and hyperphosphatemia and/or persistent hypercalcemia treated with cinacalcet. The patients were followed for 12 months. Their serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and iPTH levels were measured at baseline and on days 30, 60, 90, 180, and 365. Results: Patients with hyperphosphatemia (57.7%), hypercalcemia (23%), or both (19.3%) with iPTH > 600 pg/mL were prescribed cinacalcet. At the end of the study, decreases were observed in iPTH (1348 ± 422 vs. 440 ± 210 pg/mL; p < 0.001), Ca (9.5 ± 1.0 vs. 9.1 ± 0.6 mg/dl; p = 0.004), P (6.0 ± 1.3 vs. 4.9 ± 1.1 mg/dl; p < 0.001), and ALP (202 ± 135 vs. 155 ± 109 IU/L; p = 0.006) levels. Adverse events included hypocalcemia (26%) and digestive problems (23%). At the end of the study, 73% of the patients were on active vitamin D and cinacalcet. Three (11.5%) patients on peritoneal dialysis did not respond to therapy with cinacalcet, and their iPTH levels were never below 800 pg/mL. Conclusion: Cinacalcet combined with traditional therapy proved safe and effective and helped manage the mineral metabolism of patients with severe SHPT.

The impact of active vitamin D administration on the clinical outcomes of acne vulgaris

2020 ◽  
pp. 1-6
Author(s):  
Amal Ahmed Mohamed ◽  
Eman Mohamed Salah Ahmed ◽  
Rasha T.A. Abdel-Aziz ◽  
Halaa H. Eldeeb Abdallah ◽  
Hadeel El-Hanafi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Clinical Outcomes ◽  
Acne Vulgaris ◽  
Active Vitamin ◽  
Active Vitamin D ◽  
The Impact

scholarly journals Active vitamin D (1,25-dihydroxyvitamin D3) increases host susceptibility toCitrobacter rodentiumby suppressing mucosal Th17 responses

2012 ◽  
Vol 303 (12) ◽  
pp. G1299-G1311 ◽  
Author(s):  
Natasha R. Ryz ◽  
Scott J. Patterson ◽  
Yiqun Zhang ◽  
Caixia Ma ◽  
Tina Huang ◽  
...  
Keyword(s):  
Vitamin D ◽  
Immune Responses ◽  
Bacterial Pathogen ◽  
Enteric Bacteria ◽  
Host Susceptibility ◽  
Active Vitamin ◽  
Active Vitamin D ◽  
Increased Risk ◽  
The Impact

Vitamin D deficiency affects more that 1 billion people worldwide and is associated with an increased risk of developing a number of inflammatory/autoimmune diseases, including inflammatory bowel disease (IBD). At present, the basis for the impact of vitamin D on IBD and mucosal immune responses is unclear; however, IBD is known to reflect exaggerated immune responses to luminal bacteria, and vitamin D has been shown to play a role in regulating bacteria-host interactions. Therefore, to test the effect of active vitamin D on host responses to enteric bacteria, we gave 1,25(OH)2D3to mice infected with the bacterial pathogen Citrobacter rodentium, an extracellular microbe that causes acute colitis characterized by a strong Th1/Th17 immune response. 1,25(OH)2D3treatment of infected mice led to increased pathogen burdens and exaggerated tissue pathology. In association with their increased susceptibility, 1,25(OH)2D3-treated mice showed substantially reduced numbers of Th17 T cells within their infected colons, whereas only modest differences were noted in Th1 and Treg numbers. In accordance with the impaired Th17 responses, 1,25(OH)2D3-treated mice showed defects in their production of the antimicrobial peptide REG3γ. Taken together, these studies show that 1,25(OH)2D3suppresses Th17 T-cell responses in vivo and impairs mucosal host defense against an enteric bacterial pathogen.

Calcimimetic R-568 or calcitriol: equally beneficial on progression of renal damage in subtotally nephrectomized rats

2008 ◽  
Vol 294 (4) ◽  
pp. F748-F757 ◽  
Author(s):  
Grzegorz Piecha ◽  
Gabor Kokeny ◽  
Kumiko Nakagawa ◽  
Nadezda Koleganova ◽  
Aman Geldyyev ◽  
...  
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Kidney Damage ◽  
Receptor Protein ◽  
Membrane Thickness ◽  
Sprague Dawley ◽  
Active Vitamin ◽  
Basement Membrane Thickness ◽  
Active Vitamin D ◽  
Mean Width

Patients with renal insufficiency develop secondary hyperparathyroidism. Monotherapy with active vitamin D or calcimimetics ameliorates secondary hyperparathyroidism. We compared kidney damage in subtotally nephrectomized (SNX) rats treated with active vitamin D (calcitriol) or the calcimimetic R-568. Male Sprague-Dawley SNX and sham-operated (sham-op) rats were randomized into the following treatment groups: SNX + R-568, SNX + calcitriol, SNX + vehicle, sham-op + R-568, sham-op + calcitriol, and sham-op + vehicle. Albuminuria and blood pressure were monitored and kidneys were examined using morphometry, immunohistochemistry, quantitative RT-PCR, and in situ hybridization. Parathyroid hormone concentrations were lowered to the same extent by the two interventions, although phosphorus and the calcium-phosphorus product were reduced only by R-568 treatment. SNX rats developed marked albuminuria, which was significantly reduced in ad libitum- and pair-fed animals treated with R-568 and animals treated with calcitriol. Mean glomerular volume (6.05 ± 1.46 vs. 2.70 ± 0.91 mm3), podocyte volume (831 ± 127 vs. 397 ± 67 μm3), the degree of foot process fusion (mean width of foot processes = 958 ± 364 vs. 272 ± 35 nm), and glomerular basement membrane thickness (244 ± 6 vs. 267 ± 23 nm), as well as desmin staining, were significantly higher in vehicle-treated SNX than sham-operated animals. These changes were ameliorated with R-568 and calcitriol. In SNX, as well as sham-operated, animals, expression of the calcium-sensing receptor (protein and mRNA) was upregulated by treatment with the calcimimetic, but not calcitriol. Calcitriol and R-568 were similarly effective in ameliorating kidney damage.

The Effect of Active Vitamin D Administration on Muscle Mass in Hemodialysis Patients

2013 ◽  
Vol 33 (11) ◽  
pp. 837-846 ◽  
Author(s):  
Atsushi Mori ◽  
Tomoya Nishino ◽  
Yoko Obata ◽  
Masayuki Nakazawa ◽  
Misaki Hirose ◽  
...  
Keyword(s):  
Vitamin D ◽  
Muscle Mass ◽  
Hemodialysis Patients ◽  
Active Vitamin ◽  
Active Vitamin D

scholarly journals Impact of Chrysin on Vitamin D and Bone Health - Preclinical Studies

2020 ◽  
Author(s):  
Siva Swapna Kasarla ◽  
Sujatha Dodoala ◽  
Sunitha Sampathi ◽  
Narendra Kumar Talluri
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Health ◽  
Low Dose ◽  
Active Vitamin ◽  
Deficient Diet ◽  
Bone Parameters ◽  
Active Vitamin D ◽  
Vitamin D Levels ◽  
The Impact

AbstractVitamin D deficiency is an endemic problem existing worldwide. Although several strategies were established to enhance vitamin D3 levels, studies specifically focussing inhibition of vitamin D metabolism which may prolong the availability of active vitamin D in pathological conditions are less explored. Studies also suggest that higher doses of vitamin D3 fail to achieve optimum vitamin D levels. In this context, we focussed on the enzyme CYP3A4 which promotes inactivation of active vitamin D. The current study was aimed to decipher the impact of chrysin, a proven CYP3A4 inhibitor as an intervention and its effects in combination with low dose vitamin D3 (40 IU) and bone health in vitamin D deficiency condition. The in-vivo activity of chrysin was evaluated on female Wistar albino rats fed with a vitamin D deficient diet to attain vitamin D deficiency for 28 days. Chrysin was given alone and in combination with calcium carbonate (CaCO3) and/or vitamin D3. All the therapeutic interventions were assessed for serum 25-OH-D3 by LC-MS, biochemical, urinary, and bone parameters. Animals treated with chrysin alone and in combination with low dose vitamin D3 and/or CaCO3 showed an eminent rise in serum 25-OH-D3 levels along with increased serum biochemical parameters. On contrary, a significant decrease in the urinary parameters followed by beneficial effects on bone parameters was noticed in contrast with the vitamin D deficient diet group. Our findings revealed that although chrysin alone showed a notable effect on 25-OH-D3 and osseous tissue, comparatively it showed intensified therapeutic effect in combination with vitamin D3 and CaCO3 which can be employed as a cost-effective option to improve bone health.Graphical Abstract

scholarly journals Long-term control of secondary hyperparathyroidism by combination therapy with cinacalcet hydrochloride and intravenous active vitamin D

2012 ◽  
Vol 45 (5) ◽  
pp. 393-399
Author(s):  
Kazumichi Ohta ◽  
Hiroyuki Yamamoto ◽  
Kazunobu Kattou ◽  
Mika Ikebe ◽  
Norisato Ikebe ◽  
...  
Keyword(s):  
Vitamin D ◽  
Combination Therapy ◽  
Secondary Hyperparathyroidism ◽  
Active Vitamin ◽  
Active Vitamin D ◽  
Cinacalcet Hydrochloride
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