Oral Alfacalcidol and Coronary Artery Calcification in Predialysis Chronic Kidney Disease

Randomized Control Trial of Oral Alfacalcidol and Coronary Artery Calcification in Predialysis Chronic Kidney Disease

Active vitamin D at therapeutic dose may prevent vascular calcification but in supraphysiologic dose may precipitate it.

Active vitamin D compound is used frequently in the treatment of hyperparathyroidism in chronic kidney disease. Recent evidence from animal studies suggested that low dose of active vitamin D may be protective against vascular calcification, whereas high dose could precipitate it. The present study will examine the effect of low dose oral alfacalcidol on coronary artery calcification in predialysis chronic kidney disease patients with hyperparathyroidism.

Inclusion Criteria:

• Predialysis chronic kidney disease with GFR < 90 mL/min/1.73m2
• PTH above the upper limit of normal
• serum calcium and phosphate below the upper limit of normal

Exclusion Criteria:

• changes in GFR>15% during the past 3 months
• receive elemental calcium>500 mg/day
• currently taking active vitamin D, oral calcium with elemental calcium>500 mg/day or bisphosphonate