Vitamin D Compounds Have Uncertain Benefit in Kidney Disease

Patients with chronic kidney disease often have elevated parathyroid hormone (PTH) levels and related effects on calcium metabolism and bone. Active vitamin D compounds (e.g., 1-α-hydroxyvitamin D₃, calcitriol) are routinely prescribed to counter secondary hyperparathyroidism. To examine the effects of vitamin D compounds on biochemical and clinical outcomes, researchers conducted a meta-analysis of data from 76 randomized trials (involving 3667 patients) of active vitamin D compounds (including newer analogues) in patients with chronic kidney disease.

Older vitamin D compounds did not consistently lower PTH levels, although most studies suggested some reduction. Furthermore, older compounds increased risk for hypercalcemia and hyperphosphat…