Author Affiliations: Ohio State University, Columbus (Dr Rajagopalan) (email@example.com); and University of Toronto, Toronto, Ontario, Canada (Dr Chan).
To the Editor: In the article by Dr Thadhani and colleagues1 on the effects of paricalcitol in patients with CKD, the primary end point was change in LVMI at 48 weeks by cardiac magnetic resonance imaging, which did not significantly differ between groups. The eligibility criteria specified patients with evidence of mild to moderate left ventricular hypertrophy on echocardiography. However, the baseline LVMI reported in the study of approximately 24 g/m2.7 by cardiovascular magnetic resonance imaging would not constitute left ventricular hypertrophy using previous definitions.2,3 The absence of substantial left ventricular hypertrophy at baseline may have influenced the extent of LVMI regression with the intervention, as shown by previous studies in which the extent of left ventricular hypertrophy may influence regression.4,5 These findings must temper the authors' conclusions and should be taken into consideration in designing future trials of CKD.
Rajagopalan S, Chan CT. Vitamin D Therapy and Cardiac Function in Chronic Kidney Disease. JAMA. 2012;307(21):2253. doi:10.1001/jama.2012.4170