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Requirements of vitamin D metabolites in patients with renal disease

Requirements of vitamin D metabolites in patients with renal disease

American Journal of Clinical Nutrition 33(7): 1530-1535

The active vitamin D metabolite 1,25(OH)2D3, produced by the kidney, is deficient in patients with renal failure, and its use in treatment of patients with chronic uremia is important. A review of research is presented that indicates marked beneficial effects from long-term use of the metabolite and discusses the role of parathyroid hormones (PTH). A frequent complication of treatment with the metabolite is hypercalcemia, which may require a reduction of the dose level. Skeletal resistance to the calcemic action of PTH in renal failure patients is at least partly due to a deficiency of the metabolite. Phosphate restriction in these patients was associated with significant blood levels of the metabolite, return of PTH blood levels to normal, marked improvement in the calcemic response to PTH, normalization of intestinal calcium absorption, and healing of bone disease. A schemata is presented to explain the interaction between phosphate retention and altered vitamin D metabolism and its effects on body organs of renal failure patients.

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Accession: 000969027

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PMID: 6893103

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