The effect of oral supplementation of Paricalcitol on C-reactive protein levels in chronic kidney disease patients: GRADE-assessed systematic review and dose-response meta-analysis of data from randomized controlled trials

BMC Pharmacol Toxicol. 2024 Feb 23;25(1):19. doi: 10.1186/s40360-024-00740-y.

Abstract

Background: Previous studies investigating the effect of oral supplementation of paricalcitol on reactive protein levels in chronic kidney disease (CKD) patients reported inconsistent findings. In this systematic review and meta-analysis, we have analyzed and interpreted the results obtained from previous randomized clinical trials on the effect of paricalcitol on C-reactive protein in CKD patients in the literature.

Methods: MEDLINE, SciVerse Scopus, and Clarivate Analytics Web of Science databases were searched until January 2023 and related articles were obtained through a careful screening process allowing extraction of required data from selected articles. The effect size was calculated using a random effect model and weighted mean differences (WMD) and 95% confidence intervals (CI). Heterogeneity among studies was evaluated using Cochran's Q test and I2.

Results: Amongst the 182 articles obtained from the initial search, 4 studies (6 arms) were finally included in the meta-analysis. Pooled analysis shows that C-reactive protein levels significantly decrease after oral supplementation with paricalcitol (WMD: -2.55 mg/L, 95% CI (-4.99 to -0.11; P = 0.04). The studies used in this meta-analysis showed significant heterogeneity (I2 = 66.3% and P = 0.01).

Conclusion: Oral paricalcitol supplementation in CKD patients can significantly reduce C-reactive protein levels, which may prevent CKD progression.

Keywords: C-reactive protein; Chronic kidney disease; Meta-analysis; Paricalcitol; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • C-Reactive Protein* / analysis
  • Dietary Supplements
  • Ergocalciferols*
  • Humans
  • Randomized Controlled Trials as Topic
  • Renal Insufficiency, Chronic* / drug therapy

Substances

  • C-Reactive Protein
  • paricalcitol
  • Ergocalciferols