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June 6, 2012

Vitamin D Therapy and Cardiac Function in Chronic Kidney Disease

Author Affiliations

Author Affiliation: Department of Medicine, Washington University Medical School, St Louis, Missouri (eslatopo@dom.wustl.edu).

JAMA. 2012;307(21):2253. doi:10.1001/jama.2012.4172

To the Editor: One of the final statements by Drs Anker and von Haehling in their Editorial1 reads: “At this time, paricalcitol cannot be recommended for patients with CKD.” While the main portion of the Editorial was directed to the results of the PRIMO trial investigating the effects of oral paricalcitol on changes in LVMI in patients with CKD,2 the authors did not mention important clinical trial data that support the efficacy and safety of paricalcitol for the suppression of elevated parathyroid hormone levels in CKD populations.3,4 These studies have established paricalcitol's safety and effectiveness, when dosed according to the prescribing label. Paricalcitol has been used to treat many thousands of patients over the past 20 years. Moreover, long-term observational studies not only support the safety of paricalcitol but also suggest that it may deliver a survival benefit.5 These associations with survival, along with the findings from the PRIMO trial showing that patients with CKD who received paricalcitol had significantly fewer cardiovascular hospitalizations, indicate that more, not less, vitamin D research is warranted for this patient population.

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