Assessment of combined 24,25(OH)2D3 and 1 alpha (OH)D3 therapy for bone disease in dialysis patients.

Abstract

An increasing body of experimental data suggests a role for 24,25(OH)2D3 in bone metabolism. The present study was carried out to assess a possible therapeutic role of this vitamin D metabolite in renal osteodystrophy. Twenty-two chronic dialysis patients, most of whom were previously maintained on 1 alpha (OH)D3 therapy, received additional treatment with 10 micrograms/day 24,25(OH)2D3 and were compared to 19 patients receiving 1 alpha (OH)D3 alone. Analysis of transiliac bone biopsies obtained at study entry and following 10-16 months of treatment revealed that the combined therapy produced a decrease in bone turnover. Specifically, the addition of 24,25(OH)2D3 inhibited an increase in trabecular bone volume (BV/TV) and suppressed osteoclastic parameters. Thus BV/TV increased from 26.2 +/- 8.6 to 32.1 +/- 7.5% (p < 0.01) in the 1 alpha (OH)D3 group, but it remained unchanged in the combined therapy group. In contrast, the eroded surface (ES/BS), the osteoclast surface (Oc.S/BS), and the osteoclast numbers were significantly suppressed in patients receiving both 24,25(OH)2D3 and 1 alpha (OH)D3, as compared with those receiving 1 alpha (OH)D3 alone (p < 0.01, p < 0.01, and p < 0.001, respectively). These improvements were independent of changes in 1 alpha (OH)D3 dosage. The extent of bone aluminium deposits was unrelated to the administration of 24,25(OH)2D3 or to its effect. 24,25(OH)2D3 therapy was not associated with any adverse effects.

• Authors: M M Popovtzer, J Levi, Y Bar-Khayim, S M Shasha, G Boner, J Bernheim, C Chaimovitz, D Rubinger, U Gafter, D Gazit
• Journal: Bone (Bone) Vol. 13 Issue 5 Pg. 369-77 ( 1992) ISSN: 8756-3282 [Print] United States
• PMID: 1419378 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Hydroxycholecalciferols
• Phosphates
• 24,25-Dihydroxyvitamin D 3
• Creatinine
• Alkaline Phosphatase
• Calcium
• alfacalcidol

Topics

• 24,25-Dihydroxyvitamin D 3 (blood, therapeutic use)
• Adult
• Aged
• Alkaline Phosphatase (blood)
• Bone Density
• Calcium (blood)
• Chronic Kidney Disease-Mineral and Bone Disorder (blood, drug therapy, etiology)
• Creatinine (blood)
• Drug Therapy, Combination
• Female
• Humans
• Hydroxycholecalciferols (blood, therapeutic use)
• Male
• Middle Aged
• Phosphates (blood)
• Renal Dialysis (adverse effects)