Vitamin D Doesn't Improve Cardiac for CKD Patients

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CHICAGO—Patients with chronic kidney disease who received the vitamin D compound paricalcitol for up to 48 weeks did not show improvement on measures of cardiac structure, function, or left ventricular mass, compared to patients who received placebo, according to a study in the February 15 issue of JAMA.

"Although primarily recommended for improving bone health, treatment with vitamin D recently has been suggested for other conditions, including cardiovascular disease (CVD)," according to background in the article. The authors add that convincing data demonstrating that vitamin D therapy improves cardiovascular health are lacking. Observational studies in patients with chronic kidney disease (CKD) report associations between vitamin D deficiency and increased risk of cardiovascular events.

Ravi Thadhani, MD, MPH, of Massachusetts General Hospital, Boston, and colleagues, conducted a study (PRIMO trial) to examine whether 48-weeks of treatment with paricalcitol would reduce left ventricular mass, improve diastolic function, reduce CVD events, and improve cardiac biomarkers in patients with left ventricular hypertrophy (LVH; enlargement of the left ventricle of the heart) and CKD.

The randomized, placebo-controlled trial, which included 227 patients with chronic kidney disease and mild to moderate left ventricular hypertrophy, was conducted in 11 countries from July 2008 through September 2010. Participants were randomly assigned to receive oral paricalcitol (n = 115) or matching placebo (n = 112). Participants were predominantly male and had hypertension. Other CVD risk factors were frequent in both groups. The primary outcome for the study was the change in the left ventricular mass index over 48 weeks measured by cardiovascular magnetic resonance imaging.

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