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Paricalcitol Found to Reduce Albuminuria in Type 2 Diabetes

Vitamin D receptor activator lowers residual albuminuria in patients already on ACE/ARB

THURSDAY, Nov. 4 (HealthDay News) -- The selective vitamin D receptor activator paricalcitol can reduce albuminuria in patients with type 2 diabetes already being treated with renin-angiotensin-aldosterone system inhibitors, according to research published online Nov. 4 in The Lancet.

Dick de Zeeuw, M.D., of the University of Groningen in the Netherlands, and colleagues conducted a multinational, placebo-controlled, double-blind trial of paricalcitol at a dose of 1 or 2 µg daily to evaluate the drug's ability to reduce albuminuria in patients with diabetic nephropathy. All enrolled patients were receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. The primary end point was the percentage change in geometric mean urinary albumin-to-creatinine ratio (UACR) for the combined paricalcitol groups versus the placebo group.

The researchers found that all groups had decreases in UACR, including the placebo group, which had a 3 percent drop. The combined paricalcitol treatment group had a non-statistically significant between-group difference versus placebo of −15 percent; the 1 and 2 µg treatment groups had between-group differences versus placebo of −11 (P = 0.23) and −18 percent (P = 0.053), respectively. Early, sustained reductions in UACR were seen in the 2 µg paricalcitol group (P = 0.014 versus placebo).

"The efficacy, safety, and minimal need for monitoring of this drug should encourage future studies with hard renal outcomes to prove its renal and cardiovascular protective effects," the authors write.

The study was funded by Abbott; several authors disclosed financial ties to Abbott and other pharmaceutical and/or medical device companies.

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