title: The influence of vitamin D analogs on calcification modulators, N-terminal pro-B-type natriuretic peptide and inflammatory markers in hemodialysis patients: a randomized crossover study.
abstract: BACKGROUND
  The risk of cardiovascular disease is tremendously high in dialysis patients. Dialysis patients treated with vitamin D analogs show decreased cardiovascular morbidity and mortality compared with untreated patients. We examined the influence of two common vitamin D analogs, alfacalcidol and paricalcitol, on important cardiovascular biomarkers in hemodialysis patients. Anti-inflammatory effects and the influence on regulators of vascular calcification as well as markers of heart failure were examined.
  
  
  METHODS
  In 57 chronic hemodialysis patients enrolled in a randomized crossover trial comparing paricalcitol and alfacalcidol, we examined the changes in osteoprotegerin, fetuin-A, NT-proBNP, hs-Crp, IL-6 and TNF-α, during 16 weeks of treatment.
  
  
  RESULTS
  NT-proBNP and osteoprotegerin increased comparably in the paricalcitol and alfacalcidol-treated groups. Fetuin-A increased significantly in the alfacalcidol-treated group compared with the paricalcitol-treated group (difference 32.84 μmol/l (95% C.I.; range 0.21-67.47)) during the first treatment period. No difference was found between the groups during the second treatment period, and IL-6, TNF-α and hs-Crp were unchanged in both treatment groups.
  
  
  CONCLUSIONS
  Paricalcitol and alfacalcidol modulate regulators of vascular calcification. Alfacalcidol may increase the level of the calcification inhibitor fetuin-A. We did not find any anti-inflammatory effect or difference in changes of NT-proBNP.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00469599 May 3 2007.
authors.affiliation: Department of Nephrology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. dittehansen@dadlnet.dk.
authors.forename: Ditte
authors.initials: D
authors.lastname: Hansen
authors.forename: Knud
authors.initials: K
authors.lastname: Rasmussen
authors.forename: Lars M
authors.initials: LM
authors.lastname: Rasmussen
authors.forename: Helle
authors.initials: H
authors.lastname: Bruunsgaard
authors.forename: Lisbet
authors.initials: L
authors.lastname: Brandi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002114:Calcinosis / Q000097:blood* / Q000188:drug therapy*; D018592:Cross-Over Studies; D004872:Ergocalciferols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D006435:Renal Dialysis; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D004872:Ergocalciferols; D006887:Hydroxycholecalciferols; D018836:Inflammation Mediators; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D014807:Vitamin D; C084656:paricalcitol; C008088:alfacalcidol
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