Update on vitamin D and its newer analogues: Actions and rationale for treatment in chronic renal failure

Hartmut H. Malluche, Hanna Mawad, Nicholas J. Koszewski

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Vitamin D is an important hormone for mineral homeostasis and the proper formation and maintenance of bone. In addition, vitamin D has broader functions in the body that expand its traditionally known role in mineral balance. In chronic renal failure, calcitriol deficiency contributes to the development and progression of secondary hyperparathyroidism, bone disorders, and altered mineral metabolism. Recent revelations of the broader role of vitamin D also suggest calcitriol deficiency may contribute to decreased cardiac and immune function in chronic renal failure patients. Research on vitamin D has led to a more complete understanding of the actions of vitamin D at the transcriptional level and with respect to the clinical use of vitamin D and its analogs to control parathyroid hormone overactivity and to replace the other D hormone-dependent actions in patients with renal failure. Limitations of vitamin D and its metabolites include hypercalcemia, hyperphosphatemia and suppression of bone turnover with the risk of adynamic bone disease. Vitamin D analogs may offer greater selectivity and potentially greater safety as compared to calcitriol because of their altered relative potency on calcium and phosphorus metabolism. This review focuses on the current understanding of the biological actions of vitamin D and its analogs and the rationale for treating patients with chronic renal failure.

Original languageEnglish
Pages (from-to)367-374
Number of pages8
JournalKidney International
Issue number2
StatePublished - 2002

Bibliographical note

Funding Information:
Support for this study was provided by an unrestricted educational grant from Bone Care International.


  • Bone formation
  • Calcitriol
  • Hemodialysis
  • Hyperparathyroidism
  • Mineral homeostasis
  • Progressive renal disease

ASJC Scopus subject areas

  • Nephrology


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