Authors: Filipa Brito Mendes, Eduarda Carias, Ana Paula Silva, Pedro Leão Neves.
Background: Albuminuria is an important marker of chronic kidney disease (CKD) progression. Many drugs have been tested to reduce residual albuminuria, among them, vitamin D analogues.
Objectives: The aim of this study was to assess whether treatment with paricalcitol could be beneficial in the reduction of the urinary albumin-to-creatinine ratio (UACR) in patients with type 2 diabetes and CKD and to verify the impact of baseline vitamin D in the ratio.
Methods: Observational retrospective study, 42 patients enrolled with CKD secondary to type 2 diabetes, treated with paricalcitol, 1 μg daily during 3 months, followed in a Diabetic Nephrology consultation. Patients data were analysed at baseline (T0) and 12 weeks after treatment with paricalcitol (T1). Two groups were divided based on vitamin D baseline values to evaluate its impact on baseline UACR. We used descriptive analysis, Wilcoxon test,
Sign test and the Student's t test and percentage change in geometric mean was applied.
Results: Between T0 and T1 there was a reduction in UACR (p=0.001) and parathyroid hormone (PTH) (p=0.001), whereas vitamin D increased (p=0.0001). Estimated glomerular filtration rate (eGFR) also increased (p=0.035). Change in UACR was -1.78% and in PTH was -3.85% after 12 weeks of treatment with the study drug. Conversely, vitamin D and eGFR change increased +3.38% and +0.10% respectively, compared to baseline. Regarding vitamin D effect on baseline UACR between groups [G1 (n=40) vitamin D <10 ng/mL vs G2 (n=40) vitamin D ≥ 10 ng/mL] G1 showed higher levels of UACR (p=0.002).
Conclusion: In our study paricalcitol showed renoprotective effects in renal disease associated with type 2 diabetes, by promoting a reduction in the urinary albumin-to-creatinine ratio in this population. Moreover, there is an inverse correlation between vitamin D and UACR at baseline.
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