PTH Response to Calcitriol Reduced in African-American CKD Patients

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Among patients with stages 3-4 CKD, African-American race is associated with a decreased parathyroid hormone (PTH) response to oral calcitriol.
  • Black patients' geometric mean final PTH value was 23% higher than that of other patients.
  • They had a decrease of 19 percentage points in the probability of achieving a 30% reduction in PTH.

Among patients with stages 3-4 CKD, African-American race is associated with a decreased parathyroid hormone (PTH) response to oral calcitriol, according to a study presented at ASN's Renal Week 2009.

Abigail B. Shoben, MD, of the University of Washington in Seattle, and coworkers studied 333 patients (mean age 70 years, 98% men) with stages 3-4 CKD and hyperparathyroidism and who were taking calcitriol. All subjects had a follow-up PTH measurement one to six months after initiating calcitriol therapy. The cohort had a mean baseline PTH level of 199 pg/mL.

After adjusting for age, estimated glomerular filtration rate, BMI, diabetes, time on calcitriol, and dosage schedule, blacks had a blunted response to calcitriol, Dr. Shoben's group reported. Their geometric mean final PTH value was 23% higher than that of other patients, and they had a decrease of 19 percentage points in the probability of achieving a 30% reduction in PTH, according to the investigators.

The investigators found that concurrent use of non-activated vitamin D and benzodiazepines was associated with a greater PTH response.

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