title: Effect of vitamin-D analogue on albuminuria in patients with non-dialysed chronic kidney disease stage 4-5: a retrospective single center study.
abstract: BACKGROUND
  The vitamin D receptor activator paricalcitol has been shown to reduce albuminuria. Whether this is a unique property of paricalcitol, or common to all vitamin D analogues, is unknown. The primary aim of this study was to evaluate the effect of alfacalcidol on proteinuria, measured as 24 hour (24 h) albuminuria, in patients with chronic kidney disease (CKD) stage 4-5 being treated for secondary hyperparathyroidism (sHPT).
  
  
  METHODS
  A retrospective single-center study including adult patients with CKD 4-5, undergoing treatment for sHPT with alfacalcidol, with macroalbuminuria in minimum one 24 h urine collection. Patients were identified in a prospectively collected database of all patients with S-creatinine > 300 μM or creatinine clearance < 30 ml/min. The observation period was from 1st of January 2005 to 31st of December 2009. Phosphate binders and alfacalcidol were provided to patients free of charge.
  
  
  RESULTS
  A total of 146 macroalbuminuric patients were identified, and of these, 59 started alfacalcidol treatment during the observation period. A 12% reduction in 24 h albuminuria was seen after starting treatment. In 19 patients with no change in renin-angiotensin-aldosteron-system (RAAS) inhibition, the reduction in albuminuria was 16%. The reduction remained stable over time (9%) in a subgroup of patients (n = 20) with several urine collections before and after the start of alfacalcidol-treatment.
  
  
  CONCLUSIONS
  The present study supports experimental and clinical data on antiproteinuric actions of activated vitamin D analogues, and suggests that this may be a class-effect.
authors.affiliation: Department of Nephrology, Aarhus University Hospital, Aarhus N DK-8200, Denmark.
authors.forename: Hanne Skou
authors.initials: HS
authors.lastname: Jørgensen
authors.forename: Simon
authors.initials: S
authors.lastname: Winther
authors.forename: Johan Vestergaard
authors.initials: JV
authors.lastname: Povlsen
authors.forename: Per
authors.initials: P
authors.lastname: Ivarsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives*; D014815:Vitamins / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D006887:Hydroxycholecalciferols; D014815:Vitamins; D014807:Vitamin D; C008088:alfacalcidol