Abstract
Alfacalcidol is a widely used vitamin D compound, especially in clinical nephrology because it does not require enzymatic activation by the kidneys. For that reason it has been used for decades to treat abnormalities in bone and mineral balance that arise in chronic kidney disease. In this review an overview is provided of available experimental and clinical data that form the basis of its widespread use. Supported by studies on cell lines and animal models, clinical studies have firmly established beneficial effects of alfacalcidol on chronic-kidney disease (CKD-) related bone disease and secondary hyperparathyroidism. Its effects on muscle structure and function are not unambiguous. Neither experimental nor clinical data suggest beneficial effects of alfacalcidol on indicators of cardiovascular disease, including cardiovascular calcification, left ventricular mass function or hypertension. Suggestions of improved mortality in dialysis patients treated with alfacalcidol are based on observational cohort analyses. Integrating all available data leads the conclusion that alfacalcidol is a justifiable compound to prescribe to CKD patients with established bone disease or hyperparathyroidism. Monitoring of calcium and phosphorus levels after its initiation is required and dose adaptations should be made accordingly.
Keywords: Alfacalcidol, bone mineral density, chronic kidney disease, cardiovascular disease, CKD-MBD, secondary hyperparathyroidism, vitamin D.
Current Vascular Pharmacology
Title:Clinical Uses of 1-alpha-hydroxycholecalciferol
Volume: 12 Issue: 2
Author(s): Marc Vervloet
Affiliation:
Keywords: Alfacalcidol, bone mineral density, chronic kidney disease, cardiovascular disease, CKD-MBD, secondary hyperparathyroidism, vitamin D.
Abstract: Alfacalcidol is a widely used vitamin D compound, especially in clinical nephrology because it does not require enzymatic activation by the kidneys. For that reason it has been used for decades to treat abnormalities in bone and mineral balance that arise in chronic kidney disease. In this review an overview is provided of available experimental and clinical data that form the basis of its widespread use. Supported by studies on cell lines and animal models, clinical studies have firmly established beneficial effects of alfacalcidol on chronic-kidney disease (CKD-) related bone disease and secondary hyperparathyroidism. Its effects on muscle structure and function are not unambiguous. Neither experimental nor clinical data suggest beneficial effects of alfacalcidol on indicators of cardiovascular disease, including cardiovascular calcification, left ventricular mass function or hypertension. Suggestions of improved mortality in dialysis patients treated with alfacalcidol are based on observational cohort analyses. Integrating all available data leads the conclusion that alfacalcidol is a justifiable compound to prescribe to CKD patients with established bone disease or hyperparathyroidism. Monitoring of calcium and phosphorus levels after its initiation is required and dose adaptations should be made accordingly.
Export Options
About this article
Cite this article as:
Vervloet Marc, Clinical Uses of 1-alpha-hydroxycholecalciferol, Current Vascular Pharmacology 2014; 12 (2) . https://dx.doi.org/10.2174/15701611113119990132
DOI https://dx.doi.org/10.2174/15701611113119990132 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Novel Molecular Targets in the Treatment of Cardiac Hypertrophy
Recent Patents on Cardiovascular Drug Discovery Primary Aldosteronism: Novel Insights
Current Hypertension Reviews Vigna unguiculata Trypsin Inhibitor: A Protein with Versatile Biological Applications
Current Enzyme Inhibition Air Pollution Exposure and Blood Pressure: An Updated Review of the Literature
Current Pharmaceutical Design Antiatherosclerotic and Cardioprotective Effects of Time-Released Garlic Powder Pills
Current Pharmaceutical Design Nitrones: A Potential New Alternative as Therapeutic Agents
Current Organic Chemistry Esophagogastric Cancer: Integration of Targeted Therapies into Systemic Chemotherapy
Current Cancer Drug Targets In vivo and in silico Investigation of Antidiabetic Activity of Fruit of Withania coagulans Dunal
Current Hypertension Reviews Cardiovascular Complications of Obesity
Current Respiratory Medicine Reviews Estimating Alzheimer’s Disease Progression Rates from Normal Cognition Through Mild Cognitive Impairment and Stages of Dementia
Current Alzheimer Research The Promises and Challenges of the Use of Genomics in the Prescription of Exercise in Hypertension
Current Hypertension Reviews Combination Secondary Prevention Therapies in Vascular Diseases
Vascular Disease Prevention (Discontinued) Cardiac Innervation and Sudden Cardiac Death
Current Cardiology Reviews Interactions of VIP, Secretin and PACAP1-38 with Phospholipids: A Biological Paradox Revisited
Current Pharmaceutical Design Fat Digestion and its Role in Appetite Regulation and Energy Balance -The Importance of Enterostatin and Tetrahydrolipstatin
Current Medicinal Chemistry - Central Nervous System Agents An Efficient and Eco-Friendly Procedure for the Synthesis of Hantzsch Ethyl 1,4-Dihydro-2,6-Dimethylpyridine-3,5-Dicarboxylates Under Mild and Green Conditions
Letters in Organic Chemistry Molecular Mechanism Aspect of ER Stress in Alzheimer's Disease: Current Approaches and Future Strategies
Current Drug Targets Good at Heart: Preserving Cardiac Metabolism during aging
Current Diabetes Reviews Atrial Natriuretic Peptide: Structure, Function, and Physiological Effects: A Narrative Review
Current Cardiology Reviews Targeting Tyrosine Kinase Receptors in Hepatocellular Carcinoma
Current Cancer Drug Targets