Rheumatologie/Osteologie, Medizinisches Klinik 4, Klinikum Leverkusen, Akademisches Lehrkrankenhaus der Universität zu Köln, 51375, Leverkusen, Germany. ringe@klinikum-lev.de
Abstract
Severe vitamin D deficiency was identified only in the first decades of the last century as the most common aetiology of rickets in children and osteomalacia in adults. It was later shown that vitamin D is not, as had been supposed, the biologically active principle for healing bone disease but must be hydroxylated in the liver and then finally in the kidney to become 1alpha,25-dihydroxy-cholecalciferol, a biologically highly active renal hormone. This study reviews the various principles, mechanisms, and approaches to the treatment of different forms of osteoporosis using vitamin D, alfacalcidol, and calcitriol therapy regimens.