Kenneth Scissors, MD
Potential Financial Conflicts of Interest: None disclosed.
Scissors K. Vitamin D Compounds in Chronic Kidney Disease. Ann Intern Med. 2008;148:969. doi: 10.7326/0003-4819-148-12-200806170-00012
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Published: Ann Intern Med. 2008;148(12):969.
TO THE EDITOR:
I congratulate Palmer and colleagues (1) for exposing the lack of outcome data to support current guidelines and practices involving vitamin D therapy in chronic kidney disease. It should be noted, however, that their study addressed stage V and end-stage chronic kidney disease treated by nephrologists mainly with “active” vitamin D. But the vast majority of patients with chronic kidney disease have stage III or IV disease and are treated by primary care physicians with common vitamin D2 or D3. Palmer and colleagues' findings should not be extrapolated to imply that only patients with late-stage kidney disease benefit from treating vitamin D deficiency and preventing osteodystrophy.
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