Accordingly, it cannot be conclusively stated that taking cholecalciferol is beneficial for CKD patients. According to the results of several Hydroxylase inhibitor observational studies, the administration of calcitriol or an active form of vitamin D, which had long been conducted for controlling secondary hyperparathyroidism, was associated with lower all-cause and cardiovascular mortality in CKD patients independently of serum phosphate, calcium,

and PTH levels. However, no RCT has yet been conducted to test the finding. On the other hand, paricalcitol (not approved in Japan), a vitamin D analog that is less likely to cause hypercalcemia than calcitriol, demonstrated promising results in protecting cardiomyocytes in both experimental animal studies and human observational studies. Although a related RCT recently failed to achieve a clinically meaningful outcome in terms of cardiac remodeling, paricalcitol and other vitamin D analogs are still assumed to have a renoprotective effect by reducing the amount of proteinuria. JPH203 solubility dmso Nevertheless, this assumption needs to be elucidated in future study. Due to a lack of evidence from RCTs, administration

of an active form of vitamin D or its analogs remains controversial in that it could ameliorate overall and renal outcomes, and could help control secondary hyperparathyroidism in CKD patients; however, it is important to note that the administration of >0.5 μg/day of alfacalcidol or >0.25 μg/day however of calcitriol may induce an adverse event of hypercalcemia and subsequent kidney damage. Bibliography 1. Levin A, et al. Kidney Int. 2007;71:31–8. (Level 4)   2. Nakano C, et al. Clin J Am Soc Nephrol. 2012;7:810–9. (Level 4)   3. Wolf M, et al. Kidney Int. 2007;72:1004–13. (Level 4)   4. Pilz S, et al. Am J Kidney Dis. 2011;58:374–82. (Level 4)   5. Melamed ML, et al. Arch Salubrinal cell line Intern Med. 2008;168:1629–37. (Level 4)   6. Chonchol M, et al. Kidney Int. 2007;71:134–9. (Level 4)   7. Dobnig H, et al. Arch Intern Med. 2008;168:1340–9. (Level 4)   8. Bjelakovic G, et al. Cochrane Database Syst Rev. 2011:CD007470. (Level 1)   9. Shoji T, et al. Nephrol Dial Transplant.

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