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Nephrol Dial Transplant (1992) 7: 1207-1212
© 1992 European Renal Association-European Dialysis and Transplant Association

research-article

Effect of 1,25 (OH)2D3 treatment on glucose intolerance in uraemia

S. Türk1,, M. Yeksan1, N. Tamer1, M. Gürbilek2, Y. Erdogan1 and I Erkul3

1Department of Nephrology, University Hospital,Sekpuk University Faculty of Medicine Konya, Turkey 2Department of Biochemistry, University Hospital,Sekpuk University Faculty of Medicine Konya, Turkey 3Department of Paediatrics, University Hospital,Sekpuk University Faculty of Medicine Konya, Turkey

Correspondence and offprint requests to: Dr Suleyman Turk,Department of Nephrology, University Hospital, Selcuk University Faculty of Medicine Konya, Turkey

The aim of this study was to evaluate the effect of calcitriol treatment on glucose intolerance in uraemia

Thirty one patients on haemodialysis who had never been treated with vitamin D or related drugs, and 12 healthy control subjects with normal renal functions were studied. Uraemic patients were randomly divided into two groups; 16 patients were treated with oral calcitriol (0.5 µg/day) for 8 weeks,and 15 uraemic patients and 12 healthy subjects were given aplacebo

In all these cases, before and 8 weeks after treatment,baseline serum glucose, insulin, calcium, parathormone (PTH), and 1,25 (OH)2D3 were measured.After an oral load of 75 g glucose, blood glucose and insulin were determined at 30, 60, 90, and 120 min.The same measurementswere repeated after 8 weeks.HbAlc and fructosamine were also measured at 0 and 8 weeks

Baseline serum insulin was significantly elevated after calcitriol treatment (7.81 versus 11.63µIU/ml) there was also a significant increase in insulin following calcitriol treatment at 30, 60, 90, and 120 min

On the other hand, glycosylated haemoglobin (HbAlc) and fructosamine decreased after calcitriol treatment (HbAlc 7.09% versus 5.22% P<0.01 and fructosamine 2.92 versus 2.50 mmol/1 P<0.01)

Blood glucose significantly decreased after calcitriol treatment at 0, 30, 60, 90, and 120 min

In the other two groups there were no significant changes in any parameters

These results seem to confirm that vitamin D influences pancreatic beta (ß) cell secretion and suggest that calcitriol may improve glucose intolerance in uraemic haemodialysis patients. This effect of calcitriol is probably due to normalization of serum PTH and regulation of intracellular calcium concentration

Keywords: calcitriol; glucose intolerance; haemodialysis; insulin; uraemia


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