Calcitriol for bone disease in patients with cirrhosis of the liver

Background: Osteoporosis is associated with cirrhosis of the liver, but the effects of therapy for osteoporosis associated with cirrhosis are still co ntroversial. Methods: We evaluated the effects of calcitriol (1 alpha,25-dihydroxyvitami n D-3) on bone mineral density (BMD) in 76 patients (26 men and 50 women) w ith cirrhosis who were assigned randomly to receive calcitriol (0.5 mg twic e per day) or not. The BMD of the lumbar vertebrae was measured by dual-ene rgy X-ray absorptiometry at least twice, 12-57 months apart. Results: For men, the mean annual change in BMD was 1.1% in the treated gro up and -0.4% in the control group. The median (25th and 75th percentiles) a nnual change in BMD was 0.6 (-0.1, 2.1%) in the treated group and -1.4 (-1. 9, 1.6%) in the control group. The difference in the median annual change b etween the two groups was significant (P = 0.013). For women, the mean annu al change in BMD was -0.5% in the treated group and -2.3% in the control gr oup. The median (25th and 75th percentiles) annual change in BMD was -0.5 ( -1.8, 1.3%) in the treated group and -1.5 (-3.8, -0.7%) in the control grou p. This difference was significant (P = 0.011). Conclusions: Our results suggest that calcitriol can prevent bone loss and, therefore, may be useful for the treatment of bone disease in patients wit h cirrhosis of the liver. (C) 1999 Blackwell Science Asia Pty Ltd.