Decline in the average rate of linear growth and increased mineralization of bones in infants and children (dwarfism).Bone demineralization (osteoporosis) in adults occurs concomitantly. Widespread calcification of the soft tissues, including the heart, blood vessels, renal tubules, and lungs.Impairment of renal function with polyuria, nocturia, polydipsia, hypercalciuria, reversible azotemia, hypertension, nephrocalcinosis, generalized vascular calcification, or irreversible renal insufficiency which may result in death.Hypercalcemia with anorexia, nausea, weakness, weight loss, vague aches and stiffness, constipation, mental retardation, anemia, and mild acidosis.

These benefits should be confirmed in large and well-designed ongoing clinical trials.The effects of administered vitamin D can persist for two or more months after cessation of treatment. Furthermore, paricalcitol beneficial effects may be independent of baseline serum parathyroid hormone (PTH), calcium and phosphate levels. These beneficial effects are mediated by different actions such as reduction of oxidative stress, inflammation, downregulation of cardiac and renal renin expression, downregulation of calcifying genes and direct vascular protective effects. Paricalcitol, a selective activator of VDR, has demonstrated in several experimental and clinical studies of diabetic and non-diabetic CKD a favourable profile compared to other VDR activators, alone or as add-on to standard therapy. In chronic kidney disease (CKD) and other chronic disorders, vitamin D deficiency is very common and is associated with adverse outcomes. This is due in part to widespread expression of vitamin D receptor (VDR) on tissues and cells such as heart, kidney, immune cells, brain and muscle. Vitamin D has been recently associated with several renal, cardiovascular and inflammatory diseases, beyond mineral metabolism and bone health.

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