The Efficacy of Paricalcitol Administration for Management of Pediatric Chronic Kidney Disease: A Systematic Review and Meta-analysis

Abstract

Background There is still controversy about the efficacy of paricalcitol in children with chronic kidney disease (CKD). Therefore, the present study was designed to assess current evidence on the efficacy of paricalcitol in CKD children. Materials and Methods In this systematic review, an extensive search was performed on the databases of Medline, Embase, Scopus and Web of Science up to the end of October 2019. The keywords related to CKD and paricalcitol were combined and searched. Two independent researchers reviewed the papers; data were analyzed in STATA 14.0 statistical program and the effect of paricalcitol administration on serum levels of intact parathyroid hormone (iPTH), calcium (Ca), phosphorous (P), and Ca × P product ratio were reported as odds ratio (OR), and 95% confidence interval (95%CI). Results: Finally, data from three studies were included in the present study. Paricalcitol administration decreased iPTH levels in children with CKD (OR=0.12; 95%CI: 0.05 to 0.29; p<0.001). However, paricalcitol administration had no effect on serum calcium level (OR=1.16; 95%CI: 0.48 to 2.80; p=0.741), serum phosphorus level (OR=0.87; 95%CI: 0.38 to 1.99; p=0.735), and Ca × P ratio (OR=0.48; 95% CI: 0.15 to 1.50; p=0.208). No study has investigated the efficacy of paricalcitol on the control of proteinuria following CKD. Conclusion There is limited evidence on the efficacy and safety of paricalcitol in children with CKD. There are no studies in CKD children that have shown efficacy of Paricalcitol in controlling proteinuria.