Nephrol Dial Transplant (2001) 16: 1965-1967
© 2001 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Vitamin D analogues: how do they differ and what is their clinical role?
Department of Renal Medicine and Transplantation, Royal London Hospital, Whitechapel, London, UK
Introduction
The development of vitamin D analogues capable of effective parathyroid suppression whilst avoiding undesirable low bone turnover, hypercalcaemia and hyperphosphataemia has received considerable attention over the last decade [1]. Much in vitro and animal work has been undertaken with frustrating disparity emerging between therapeutic potential in the experimental setting and performance in available clinical trials. The biology and, in particular, gene regulatory properties of vitamin D are now more fully understood [2] and provide useful insights into the mechanisms underpinning the selective properties encountered experimentally. The formulation of designer compounds possessing distinct physiological characteristics that will afford them an advantage in the clinical arena remains an enticing prospect.
Vitamin D in uraemia
Vitamin D biology
Vitamin D and its metabolites are transported in the circulation by a specific binding protein, vitamin D binding protein (DBP), which is normally present in large excess. Active vitamin D, 1
,25-dihydroxyvitamin D3 (1,25(OH)2D3 or calcitriol), is
Vitamin D in the pathophysiology of secondary hyperparathyroidism and osteodystrophy
The vitamin D analogues
Clinical experience with the new analogues
Conclusions
Notes
References
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