BACKGROUND: The progression of diabetic kidney disease (DKD) is highly correlated with proteinuria. Previous studies have suggested that vitamin D treatment may reduce proteinuria and has the potential to delay the progression of renal disease. OBJECTIVE: To evaluate efficacy of oral calcitriol to decrease proteinuria in type 2 diabetic mellitus (T2DM) patients with DKD. MATERIAL AND METHOD: In this 16-week, open label, prospective, randomized controlled study, 91 patients with T2DM with estimated glomerular filtration rate (eGFR) greater than 15 ml/min/1.73 m2 and urine protein to creatinine ratio (UPCR) greater than 1 g/g were enrolled. They were randomly assigned to receive either oral calcitriol 0.5 mcg twice weekly (n = 46) or without oral calcitriol (n = 45). The primary outcome was determined by the change of UPCR from baseline after 16 weeks of treatment of both groups. RESULTS: At randomization, the mean UPCR was 3.7 + 2.2 g/g in the calcitriol group and 3.4 +/- 2.1 g/g in the control group. The mean UPCR at 16-week follow-up was 2.9 +/- 1.7 g/g in the calcitriol group and 3.5 +/- 2.3 g/g in the control group. Percent changes in UPCR from baseline to the last evaluation in the calcitriol and control groups were -18.7% and +9.9% (p < 0.01) respectively. Patients with 30% or more decrement in proteinuria occurred 43.5% of the time in the calcitriol group and 11.1% in the control group (p < 0.01). The eGFR and blood pressure did not differ significantly between the two groups. No serious adverse side effects were noted in either group. CONCLUSION:Calcitriol treatment can reduce proteinuria in patients with DKD without serious adverse events.
RCT Entities:
BACKGROUND: The progression of diabetic kidney disease (DKD) is highly correlated with proteinuria. Previous studies have suggested that vitamin D treatment may reduce proteinuria and has the potential to delay the progression of renal disease. OBJECTIVE: To evaluate efficacy of oral calcitriol to decrease proteinuria in type 2 diabetic mellitus (T2DM) patients with DKD. MATERIAL AND METHOD: In this 16-week, open label, prospective, randomized controlled study, 91 patients with T2DM with estimated glomerular filtration rate (eGFR) greater than 15 ml/min/1.73 m2 and urine protein to creatinine ratio (UPCR) greater than 1 g/g were enrolled. They were randomly assigned to receive either oral calcitriol 0.5 mcg twice weekly (n = 46) or without oral calcitriol (n = 45). The primary outcome was determined by the change of UPCR from baseline after 16 weeks of treatment of both groups. RESULTS: At randomization, the mean UPCR was 3.7 + 2.2 g/g in the calcitriol group and 3.4 +/- 2.1 g/g in the control group. The mean UPCR at 16-week follow-up was 2.9 +/- 1.7 g/g in the calcitriol group and 3.5 +/- 2.3 g/g in the control group. Percent changes in UPCR from baseline to the last evaluation in the calcitriol and control groups were -18.7% and +9.9% (p < 0.01) respectively. Patients with 30% or more decrement in proteinuria occurred 43.5% of the time in the calcitriol group and 11.1% in the control group (p < 0.01). The eGFR and blood pressure did not differ significantly between the two groups. No serious adverse side effects were noted in either group. CONCLUSION:Calcitriol treatment can reduce proteinuria in patients with DKD without serious adverse events.
Authors: Rukshana Shroff; Helen Aitkenhead; Nikola Costa; Antonella Trivelli; Mieczyslaw Litwin; Stefano Picca; Ali Anarat; Peter Sallay; Fatih Ozaltin; Aleksandra Zurowska; Augustina Jankauskiene; Giovanni Montini; Marina Charbit; Franz Schaefer; Elke Wühl Journal: J Am Soc Nephrol Date: 2015-06-11 Impact factor: 10.121
Authors: Luigi Francesco Morrone; Pergiorgio Bolasco; Corrado Camerini; Giuseppe Cianciolo; Adamasco Cupisti; Andrea Galassi; Sandro Mazzaferro; Domenico Russo; Luigi Russo; Mario Cozzolino Journal: J Nephrol Date: 2016-04-09 Impact factor: 3.902
Authors: Martin H de Borst; Reza Hajhosseiny; Hector Tamez; Julia Wenger; Ravi Thadhani; David J A Goldsmith Journal: J Am Soc Nephrol Date: 2013-08-08 Impact factor: 10.121
Authors: João Soares Felício; Alana Ferreira de Oliveira; Amanda Soares Peixoto; Ana Carolina Contente Braga de Souza; João Felício Abrahão Neto; Franciane Trindade Cunha de Melo; Carolina Tavares Carvalho; Manuela Nascimento de Lemos; Sávio Diego Nascimento Cavalcante; Fabricio de Souza Resende; Márcia Costa Dos Santos; Ana Regina Motta; Luísa Corrêa Janaú; Elizabeth Sumi Yamada; Karem Miléo Felício Journal: Front Endocrinol (Lausanne) Date: 2017-08-14 Impact factor: 5.555