Falls are associated with decreased renal function and insufficient calcitriol production by the kidney

John Christopher G. Gallagher, Prema Rapuri, Lynette Smith

Research output: Contribution to journalArticle

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Abstract

In a double blind placebo controlled 3-year osteoporosis study in elderly women, we collected prospective data on falls. The study population comprised 489 normal elderly women aged 65-77 years randomized to four groups: placebo, calcitriol 0.25 mcg b.i.d., conjugated equine estrogens (0.625 mg/day) and calcitriol + estrogen. Falls occurred in 57% of all women. Using a Poisson regression model, the placebo group with low GFR-creatinine clearance (CrCl <60 ml/min) had 60% more falls compared to the group with CrCl ≥ 60 ml/min. Further sub group analyses showed that there is no increased risk of falls with CrCl 60-70, 70-80 and >90 ml/min. Calcitriol treatment significantly reduced the number of falls by 50% (OR = 0.5, 95% CI: 0.4-0.9, p = 0.010) compared to placebo in the low CrCl group. The group with lower CrCl had lower calcium absorption (p <0.001), lower serum 1,25-dihydroxyvitamin D (1,25(OH)2D) (p <0.001) and normal serum 25OHD suggesting that there is decreased conversion of 25OHD to 1,25(OH)2D by the aging kidney. It is postulated that the decrease in falls on calcitriol therapy is related to an increase in serum 1,25(OH)2D, upregulation of VDR and improvement in muscle strength although one cannot exclude an effect on the central nervous system.

Original languageEnglish
Pages (from-to)610-613
Number of pages4
JournalJournal of Steroid Biochemistry and Molecular Biology
Volume103
Issue number3-5
DOIs
StatePublished - Mar 2007

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Calcitriol
Placebos
Kidney
Serum
Conjugated (USP) Estrogens
Muscle Strength
Neurology
Osteoporosis
Muscle
Creatinine
Estrogens
Up-Regulation
Central Nervous System
Aging of materials
Calcium
Therapeutics
Population

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Endocrinology

Cite this

Falls are associated with decreased renal function and insufficient calcitriol production by the kidney. / Gallagher, John Christopher G.; Rapuri, Prema; Smith, Lynette.

In: Journal of Steroid Biochemistry and Molecular Biology, Vol. 103, No. 3-5, 03.2007, p. 610-613.

Research output: Contribution to journalArticle

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