Effects of calcitriol and paricalcitol on renal fibrosis in CKD

Nephrol Dial Transplant. 2021 Apr 26;36(5):793-803. doi: 10.1093/ndt/gfaa373.

Abstract

Background: In chronic kidney disease, the activation of the renin-angiotensin-aldosterone system (RAAS) and renal inflammation stimulates renal fibrosis and the progression to end-stage renal disease. The low levels of vitamin D receptor (VDR) and its activators (VDRAs) contribute to worsen secondary hyperparathyroidism and renal fibrosis.

Methods: The 7/8 nephrectomy model of experimental chronic renal failure (CRF) was used to examine the anti-fibrotic effects of treatment with two VDRAs, paricalcitol and calcitriol, at equivalent doses (3/1 dose ratio) during 4 weeks.

Results: CRF increased the activation of the RAAS, renal inflammation and interstitial fibrosis. Paricalcitol treatment reduced renal collagen I and renal interstitial fibrosis by decreasing the activation of the RAAS through renal changes in renin, angiotensin receptor 1 (ATR1) and ATR2 mRNAs levels and renal inflammation by decreasing renal inflammatory leucocytes (CD45), a desintegrin and metaloproteinase mRNA, transforming growth factor beta mRNA and protein, and maintaining E-cadherin mRNA levels. Calcitriol showed similar trends without significant changes in most of these biomarkers.

Conclusions: Paricalcitol effectively attenuated the renal interstitial fibrosis induced by CRF through a combination of inhibitory actions on the RAAS, inflammation and epithelial/mesenchymal transition.

Keywords: CKD; VDRAs; epithelial/mesenchymal-transition; inflammatory infiltration; renal fibrosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biomarkers / metabolism
  • Calcitriol* / pharmacology
  • Ergocalciferols
  • Fibrosis
  • Hyperparathyroidism, Secondary / drug therapy
  • Inflammation / metabolism
  • Kidney / metabolism
  • Kidney Failure, Chronic / complications
  • Receptors, Calcitriol / metabolism
  • Renal Insufficiency, Chronic / complications
  • Renin / metabolism
  • Renin-Angiotensin System / drug effects

Substances

  • Biomarkers
  • Ergocalciferols
  • Receptors, Calcitriol
  • VDR protein, human
  • paricalcitol
  • Renin
  • Calcitriol