0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Vitamin D in Patients with Chronic Kidney Disease: Nothing New under the Sun

Marcello Tonelli, MD, SM
[+] Article and Author Information

From University of Alberta and Institute of Health Economics, Edmonton, Alberta T6G 2G3, Canada.


Grant Support: Dr. Tonelli is supported by salary awards from the Canadian Institutes of Health Research and the Alberta Heritage Foundation for Medical Research.

Potential Financial Conflicts of Interest: Dr. Tonelli holds peer-reviewed research funding from the Centre for D-Receptor Activation Research to examine vitamin D status in remote-dwelling patients on dialysis.

Current Author Address: Marcello Tonelli, MD, SM, 7-129 Clinical Sciences Building, 8440-112 Street, Edmonton, Alberta T6G 2G3, Canada; e-mail, no_reprints@med.ualberta.ca.


Ann Intern Med. 2007;147(12):880-881. doi:10.7326/0003-4819-147-12-200712180-00009
Text Size: A A A

Vitamin D deficiency—a common occurrence in patients with chronic kidney disease—plays an integral role in the development of secondary hyperparathyroidism, which in turn can lead to bone fractures and disability. The active form of vitamin D has hydroxyl groups at the 1 and 25 positions. Current options for vitamin D replacement in patients with chronic kidney disease include nonhydroxylated vitamin D (ergocalciferol, cholecalciferol), 25-hydroxyvitamin D, and activated forms. The latter include 1,25-hydroxyvitamin D and the 1-hydroxylated prohormone, which is subsequently 25-hydroxylated by the liver. Because 1-hydroxylase activity is impaired in chronic kidney disease, activated vitamin D offers theoretical advantages over vitamin D compounds that are not 1-hydroxylated and has been prescribed to dialysis patients for more than 20 years. Initially 1,25 hydroxyvitamin D (calcitriol) was used, although the use of vitamin D analogues (chemically modified dihydroxylated compounds, such as paricalcitol and doxercalciferol) is increasingly common.

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)