Carbamazepin antagonizes the vitamin D-mediated suppression of secondary hyperparathyroidism: Pathogenesis and therapeutical options

Abstract

This commentary updates: 1) the patophisiology responsible for carbamazepine-induced resistance to paricalcitol suppression of PTH in CKD; 2) the contribution of vitamin D deficiency to the adverse effects of carbamazepine; 3) the benefits of cholecalciferol supplementation either alone or in combination with paricalcitol in preventing/attenuating the onset of resistance to vitamin D suppression of secondary hyperparathyroidism (SHPT); 4) the successful correction of vitamin D deficiency in chronic kidney disease (CKD) patients receiving anti-epileptic medication other than carbamazepine, with the goal of providing nephrologists with a practical, safe and efficacious therapeutic approach to improve outcomes in SHPT.