Comparative efficacy and safety of paricalcitol versus vitamin D receptor activators for dialysis patients with secondary hyperparathyroidism: a meta-analysis of randomized controlled trials.
BMC Nephrol. 2017 Aug 25;18(1):272. doi: 10.1186/s12882-017-0691-6.
Xie Y1, Su P2, Sun Y3, Zhang H4, Zhao R2, Li L2, Meng L2.
- Search ViitaminDWiki for “Vitamin D receptor activator” OR VDRA OR paricalcitol OR “Vitamin D Receptor agonists” 480 items as of Aug 2017
- Vitamin D Receptor Activator might help treat or prevent various diseases
Vitamin D Receptor category has the following
Vitamin D tests cannot detect Vitamin D Receptor (VDR) problems
A poor VDR restricts Vitamin D from getting in the cells
It appears that 30% of the population have a poor VDR (40% of the Obese )
Several diseases protect themselves by deactivating the Vitamin D receptor. Example: Breast Cancer
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The Vitamin D Receptor is associated with many health problems
Some health problems, such as Breast Cancer, Diabetes, and COVID protect themselves by reducing VDR activation
55 health problems associated with poor VDR
A poor VDR is associated with the risk of 55 health problems click here for details
The risk of 48 diseases at least double with poor VDR as of Jan 2023 click here for details
Some health problem, such as Breast Cancer reduce the VDR
VDR at-home test $29 - results not easily understood in 2016
There are hints that you may have inherited a poor VDR
How to increase VDR activation
Compensate for poor VDR by increasing one or more:
| Increasing | Increases |
| 1) Vitamin D supplement Sun Ultraviolet -B | Vitamin D in the blood and thus in the cells |
| 2) Magnesium | Vitamin D in the blood AND in the cells |
| 3) Omega-3 | Vitamin D in the cells |
| 4) Resveratrol | Vitamin D Receptor |
| 5) Intense exercise | Vitamin D Receptor |
| 6) Get prescription for VDR activator paricalcitol, maxacalcitol? | Vitamin D Receptor |
| 7) Quercetin (flavonoid) | Vitamin D Receptor |
| 8) Zinc is in the VDR | Vitamin D Receptor |
| 9) Boron | Vitamin D Receptor ?, etc |
| 10) Essential oils e.g. ginger, curcumin | Vitamin D Receptor |
| 11) Progesterone | Vitamin D Receptor |
| 12) Infrequent high concentration Vitamin D Increases the concentration gradient | Vitamin D Receptor |
| 13) Sulfroaphane and perhaps sulfur | Vitamin D Receptor |
| 14) Butyrate especially gut | Vitamin D Receptor |
| 15) Berberine | Vitamin D Receptor |
Note: If you are not feeling enough benefit from Vitamin D, you might try increasing VDR activation. You might feel the benefit within days of adding one or more of the above
Far healthier and stronger at age 72 due to supplements Includes 6 supplements that help the VDR
Download the PDF from VitaminDWiki
BACKGROUND:
Secondary hyperparathyroidism (SHPT) is a severe complication for dialysis patients. Vitamin D receptor activators (VDRAs) are used to treat SHPT, but the comparative efficacy and safety between paricalcitol and other vitamin D receptor activators for management of SHPT in dialysis patients has been unproven.
METHODS:
We searched PubMed, Embase, and the Cochrane Library for the time period through June 2017 to identify randomized controlled trials that evaluated paricalcitol compared with other VDRAs for treatment of SHPT. The primary outcome was the percentage of patients with target reduction of intact parathyroid hormone (iPTH) from baseline. Secondary outcomes included incidences of hypercalcemia and hyperphosphatemia. The random-effects model was used to estimate relative risks (RRs) with 95% confidence intervals (CIs).
RESULTS:
Eight studies (N = 759) were eligible for final inclusion. Compared with other VDRAs, no significant differences were found in the percentage of patients with target reduction of intact parathyroid hormone (iPTH) from baseline for paricalcitol treatment of SHPT in dialysis patients (RR, 1.01; 95% CI, 0. 87-1.18; p = 0.85). There were no differences in the incidence of hypercalcemia (RR, 0.95; 95% CI, 0.74-1.21; p = 0. 65) and hyperphosphatemia (RR, 0.94; 95% CI, 0.77-1.16; p = 0.58).
CONCLUSIONS:
The presently available evidence is insufficient to draw a conclusion regarding whether paricalcitol therapy has a comparative efficacy and safety over other VDRAs for treating dialysis patients with SHPT. Large-sample, well-conducted, high-quality RCTs with patient-level outcomes (i.e., mortality) are urgently needed.
PMID: 28841848 DOI: 10.1186/s12882-017-0691-6
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