The metabolic fate of vitamin D<sub>3</sub>-<sup>3</sup>H in chronic renal failure

Louis V. Avioli; Stanley Birge; Sook Won Lee; Eduardo Slatopolsky

doi:10.1172/JCI105909

¹Renal and Endocrine Divisions, Department of Medicine, Washington University School of Medicine, and The Jewish Hospital of St. Louis, St. Louis, Missouri 63110

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¹Renal and Endocrine Divisions, Department of Medicine, Washington University School of Medicine, and The Jewish Hospital of St. Louis, St. Louis, Missouri 63110

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¹Renal and Endocrine Divisions, Department of Medicine, Washington University School of Medicine, and The Jewish Hospital of St. Louis, St. Louis, Missouri 63110

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¹Renal and Endocrine Divisions, Department of Medicine, Washington University School of Medicine, and The Jewish Hospital of St. Louis, St. Louis, Missouri 63110

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Published in Volume 47, Issue 10 on October 1, 1968
J Clin Invest. 1968;47(10):2239–2252. https://doi.org/10.1172/JCI105909.
© 1968 The American Society for Clinical Investigation

Published October 1, 1968 - Version history

The absorption and metabolism of vitamin D₃-³H was studied in eight patients with chronic renal failure. Although the intestinal absorption of vitamin D₃-³H was normal, the metabolic fate of the vitamin was abnormal as characterized by a twofold increase in fractional turnover rate, an abnormal accumulation of biologically inactive lipid-soluble metabolites, and the urinary excretion of both vitamin D₃-³H and biologically inactive metabolites. Neither alterations in water-soluble vitamin D₃ metabolites nor qualitative abnormalities in protein-binding of vitamin D₃ were observed in the uremic subjects. Although hemodialysis proved ineffectual in reversing the observed abnormalities in vitamin D₃ metabolism and excretion, renal homotransplantation was completely successful in this regard. These experiments support the conclusion that the resistance to therapeutic doses of vitamin D often seen in patients with chronic renal failure and renal osteodystrophy results from an acquired defect in the metabolism and excretion of vitamin D.