Paricalcitol, a selective vitamin D receptor activator, increases hemoglobin levels, including in patients without chronic kidney disease (CKD) or secondary hyperparathyroidism (SHPT). Investigators reported the new findings in a poster presentation at the American Society of Nephrology’s Kidney Week 2022 meeting in Orlando, Florida.
“These results represent a real opportunity for exploring the use of paricalcitol as a safe and effective therapy for renal anemia,” Miguel Uriol Rivera, MD, PhD, of Hospital Universitari Son Espases, Palma de Mallorca in Spain, told Renal & Urology News.
Dr Rivera’s team stratified 40 patients (mean age 57 years; 35% female) treated with paricalcitol by their anemia, CKD, and SHPT status.
At 6 months of follow-up, hemoglobin levels had significantly increased 0.9 and 0.7 g/dL in patients with and without SHPT, 0.9 and 0.6 g/dL in patients with and without CKD, and 0.9 and 0.6 g/dL in patients with and without anemia, respectively. None of the patients had received erythropoiesis-stimulating agents, iron supplements, or recent blood transfusion.
A pitfall of anemia treatment with erythropoiesis-stimulating agents is it can increase the number of immature and irregular reticulocytes above an acceptable physiologic range. In the study, paricalcitol treatment increased the number of red blood cells in each group, while maintaining red cell distribution width, mean corpuscular volume, and mean corpuscular hemoglobin. Dr Rivera believes the drug may improve red cell life span.
“Renal anemia involves inflammation and accelerated red blood cell death,” Dr Rivera explained. “Paricalcitol’s effects on anemia were not related either to parathyroid hormone levels or uremic toxins. Rather, the drug may have anti-inflammatory and anti-aging properties.”
