1,25-dihydroxycholecalciferol and parathyroid hormone in advanced chronic renal failure: effects of simultaneous protein and phosphorus restriction
Lucas, P.A.; Brown, R.C.; Woodhead, J.S.; Coles, G.A.
Clinical Nephrology 25(1): 7-10
1986
ISSN/ISBN: 0301-0430 PMID: 3754187 Document Number: 278051
Vitamin D3 metabolites and immunoreactive parathyroid hormone (iPTH) were measured in sera obtained from subjects with advanced chronic renal failure (CRF) (creatinine clearance < 10 ml/min) before and after 3 months on a diet very low in protein (< 0.2 g/kg/day), phosphorus (< 500 mg/day), and supplemented with a mixture of essential amino acids and ketoacid analogues of essential amino acids. iPTH and phosphate fell in all subjects (p < 0.02). 1,25-dihydroxycholecalciferol (1,25[OH]2D3) fell in all but one of the subjects (p < 0.02), while no significant change was seen in creatinine clearance or in serum 25-hydroxycholecalciferol [25[OH]D3] levels. A strongly positive correlation was found between initial serum levels of 25(OH)D3 and 1,25(OH)2D3 (r = 0.95, p < 0.001). Thus in contrast with the reported effects of dietary phosphorus reduction in subjects with early and moderate CRF and in normal subjects, this regime was associated with decreased 1,25(OH)2D3 levels in subjects with advanced CRF.