title: Differential influence of vitamin D analogs on left ventricular mass index in maintenance hemodialysis patients.
abstract: OBJECTIVE
  Secondary hyperparathyroidism (SHPT) is a common feature in maintenance hemodialysis (MHD) patients. Inadequate treatment of SHPT has been associated with cardiovascular complications, and vitamin D therapy might influence the development of cardiovascular diseases. In the present study, we aimed to evaluate the effects of intravenous paricalcitol and calcitriol treatments on left ventricular mass index changes in MHD patients.
  
  
  METHODS
  We conducted an observational study with a 12-month follow-up duration to compare the outcomes of intravenous paricalcitol and calcitriol treatments in MHD patients. Eighty patients with moderate to severe SHPT were enrolled in the study. All the patients had normalized total serum Ca concentration <10.5 mg/dL, serum calcium-phosphorus product (Ca × P) <75, and parathyroid hormone level (PTH) level ≥300 pg/mL at the begining of the follow-up period.
  
  
  RESULTS
  The patients were divided into a paricalcitol group (n = 40) and a calcitriol group (n = 40). The demographic, clinical, and biochemical characteristics of the patients were similar at baseline. We observed significantly superior control of SHPT; lesser frequency of hypercalcemia and hyperphosphatemia, and Ca × P level elevations; and interruption of vitamin D treatment in the paricalcitol group. Moreover, we found no significant change in left ventricular mass index in the paricalcitol group, but found a significantly increased left ventricular mass index in the calcitriol group during the follow-up period (from 136.6 ± 35.2 g/m2 to 132.9 ± 40.4 g/m2 vs. from 137.2 ± 30.1 g/m2 to 149.4 ± 31.0 g/m2; p<0.044).
  
  
  CONCLUSIONS
  We observed that, compared with calcitriol therapy, paricalcitol therapy reduced the PTH concentrations more effectively without causing hypercalcemia and hyperphosphatemia and might have a substantial beneficial effect on the development of left ventricular hypertrophy.
authors.affiliation: 1 Department of Nephrology, Faculty of Medicine, Baskent University, Ankara - Turkey.
authors.forename: Siren
authors.initials: S
authors.lastname: Sezer
authors.forename: Emre
authors.initials: E
authors.lastname: Tutal
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Bal
authors.forename: Mehtap Erkmen
authors.initials: ME
authors.lastname: Uyar
authors.forename: Ugur
authors.initials: U
authors.lastname: Bal
authors.forename: Ulkem
authors.initials: U
authors.lastname: Cakir
authors.forename: Nurhan Ozdemir
authors.initials: NO
authors.lastname: Acar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D002117:Calcitriol / Q000008:administration & dosage*; D016903:Drug Monitoring / Q000379:methods; D004872:Ergocalciferols / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000378:metabolism; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D004872:Ergocalciferols; D014815:Vitamins; D014807:Vitamin D; C084656:paricalcitol; D002117:Calcitriol