title: Effect of paricalcitol on renin and albuminuria in non-diabetic stage III-IV chronic kidney disease: a randomized placebo-controlled trial.
abstract: BACKGROUND
  Vitamin D receptor activators reduce albuminuria, and may improve survival in chronic kidney disease (CKD). Animal studies suggest that these pleiotropic effects of vitamin D may be mediated by suppression of renin. However, randomized trials in humans have yet to establish this relationship.
  
  
  METHODS
  In a randomized, placebo-controlled, double-blinded crossover study, the effect of oral paricalcitol (2 μg/day) was investigated in 26 patients with non-diabetic, albuminuric stage III-IV CKD. After treatment, plasma concentrations of renin (PRC), angiotensin II (AngII) and aldosterone (Aldo) were measured. GFR was determined by 51Cr-EDTA clearance. Assessment of renal NO dependency was performed by infusion of NG-monomethyl-L-arginine (L-NMMA). Albumin excretion rate (AER) was analyzed in 24-h urine and during 51Cr-EDTA clearance.
  
  
  RESULTS
  Paricalcitol did not alter plasma levels of renin, AngII, Aldo, or urinary excretion of sodium and potassium. A modest reduction of borderline significance was observed in AER, and paricalcitol abrogated the albuminuric response to L-NMMA.
  
  
  CONCLUSIONS
  In this randomized, placebo-controlled trial paricalcitol only marginally decreased AER and did not alter circulating levels of renin, AngII or Aldo. The abrogation of the rise in albumin excretion by paricalcitol during NOS blockade may indicate that favourable modulation of renal NO dependency could be involved in mediating reno-protection and survival benefits in CKD.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT01136564.
authors.forename: Thomas
authors.initials: T
authors.lastname: Larsen
authors.forename: Frank H
authors.initials: FH
authors.lastname: Mose
authors.forename: Jesper N
authors.initials: JN
authors.lastname: Bech
authors.forename: Erling B
authors.initials: EB
authors.lastname: Pedersen
mesh_terms: D000419:Albuminuria / Q000097:blood* / Q000188:drug therapy*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004872:Ergocalciferols / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000188:drug therapy*; D012083:Renin / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D004872:Ergocalciferols; C084656:paricalcitol; D012083:Renin
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