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SERUM CONCENTRATIONS OF METABOLITES OF VITAMIN D IN PATIENTS WITH CHRONIC RENAL FAILURE (CRF). CONSEQUENCES FOR THE TREATMENT WITH 1‐α‐HYDROXY‐DERIVATIVES
Author(s) -
JUTTMANN J. R.,
BUURMAN C. J.,
KAM E.,
VISSER T. J.,
BIRKENHÄGER J. C.
Publication year - 1981
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1981.tb00191.x
Subject(s) - medicine , endocrinology , sephadex , cholecalciferol , vitamin d and neurology , chemistry , metabolite , parathyroid hormone , calcifediol , radioimmunoassay , creatinine , hypercalcaemia , ergocalciferol , renal function , high performance liquid chromatography , vitamin , vitamin d deficiency , calcium , enzyme , chromatography , biochemistry
SUMMARY In forty‐two patients with chronic renal failure (CRF), serum concentrations of 25‐hydroxy‐cholecalciferol (25‐OHCC), 24,25‐dihydroxy‐cholecalciferol (24,25‐OH 2 CC) and 1,25‐dihydroxy‐cholecalciferol (1,25‐OH 2 CC) were measured before and during intermittent haemodialysis (IHD) and in a few cases also after renal transplantation. 25‐OHCC and 24,25‐OH 2 CC were measured by means of a competitive protein binding assay after Sephadex LH 20 chromatography and 1,25‐OH 2 CC by means of a radioimmunoassay after Sephadex LH 20 and high pressure liquid chromatography (HPLC). In our patients serum values for 25‐OHCC and 24,25‐OH 2 CC showed a seasonal fluctuation as in normal individuals. The concentrations in the serum of 24,25‐OH 2 CC and 1,25‐OH 2 CC showed a positive correlation with renal function. With regard to 24,25‐OH 2 CC this correlation was only found for the 24,25‐OH 2 CC: 25‐OHCC ratio which was used to eliminate the seasonal fluctuation. For both dihydroxylated metabolites subnormal concentrations were found when the creatinine clearance was 40–50 ml/min and lower. It appears that the decrease of the plasma level of these metabolites of Vitamin D preceeds (or is concomitant with) the changes in the serum values of calcium (Ca), phosphorus (P) and parathyroid hormone (PTH) and the diminution of the intestinal absorption of Ca. These findings indicate that patients with CRF should be treated at an early stage of the disease with 1α‐hydroxy‐derivatives of Vitamin D in order to prevent the development of, or to induce the healing of, bone‐lesions of renal osteodystrophy.