Christiansen C
J Steroid Biochem. 1983 Jul;19(1B):517-23. doi: 10.1016/0022-4731(83)90212-1.
Seventeen undialysed adult patients with chronic renal failure took part in a controlled study of the effects of 1,25(OH)2D3 and D3. After a 6-month observation period the patients were allocated at random to 2 groups for 6 months of treatment with either 1,25(OH)2D3 (mean dose 0.5 micrograms daily) or D3 (dose 100 micrograms daily). Treatment was then discontinued and the patients were studied for a further 3 months. The patients as a group initially had a moderate renal osteodystrophy. During treatment serum iPTH decreased in both groups but most markedly in the 1,25(OH)2D3 group in which the iPTH values became normal. Serum creatinine increased during treatment in both groups, in the group receiving 1,25(OH)2D3 this was coupled with an increase in serum calcium to within the normal range. Our data demonstrate that 1,25(OH)2D3 treatment in patients with chronic renal failure leads to a further reduction in renal function, which may be partially reversible. Physicians should therefore be reluctant to give vitamin D analogues to patients with chronic renal failure unless they have severe symptomatic renal osteodystrophy.
17名未接受透析的成年慢性肾衰竭患者参与了一项关于1,25(OH)₂D₃和D₃疗效的对照研究。经过6个月的观察期后，患者被随机分为两组，分别接受为期6个月的1,25(OH)₂D₃（平均每日剂量0.5微克）或D₃（每日剂量100微克）治疗。然后停止治疗，对患者再进行3个月的研究。患者总体最初患有中度肾性骨营养不良。治疗期间两组患者的血清甲状旁腺激素（iPTH）均下降，但在1,25(OH)₂D₃组下降最为明显，该组iPTH值恢复正常。两组患者治疗期间血清肌酐均升高，在接受1,25(OH)₂D₃治疗的组中，这伴随着血清钙升高至正常范围。我们的数据表明，慢性肾衰竭患者接受1,25(OH)₂D₃治疗会导致肾功能进一步下降，这可能部分是可逆的。因此，除非患者患有严重症状性肾性骨营养不良，否则医生应避免给慢性肾衰竭患者使用维生素D类似物。
