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Randomized controlled trial of cholecalciferol supplementation in chronic kidney disease patients with

Peter Marckmann1, Hanne Agerskov, Sasikala Thineshkumar

  • 1Clinical Research Unit, Department of Nephrology, Odense University Hospital, Odense, Denmark. peter.marckmann@dadlnet.dk

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|July 24, 2012
PubMed

Insights

Vitamin D (25-hydroxyvitamin D) replenishment effectively raised levels in chronic kidney disease (CKD) patients. Non-dialysis CKD patients showed improved vitamin D metabolism and reduced parathyroid hormone, but hypercalcemia risk necessitates monitoring.

Area of Science:

  • Nephrology
  • Endocrinology
  • Nutritional Science

Background:

  • Hypovitaminosis D is prevalent in chronic kidney disease (CKD) patients.
  • The impact of 25-hydroxyvitamin D (25-OHD) repletion in CKD requires further elucidation.

Purpose of the Study:

  • To assess the efficacy of cholecalciferol supplementation for 25-OHD replenishment in CKD patients.
  • To investigate the effects of 25-OHD replenishment on vitamin D metabolites, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF-23), and cardiovascular biomarkers.

Main Methods:

  • An 8-week, randomized, placebo-controlled, double-blind study in hemodialysis (HD) and non-HD CKD patients.
  • Weekly oral cholecalciferol (40,000 IU) administration.
  • Analysis of 25-OHD, 1,25-dihydroxyvitamin D (1,25-diOHD), PTH, FGF-23, calcium, phosphate, cardiovascular biomarkers, and health outcomes.

Main Results:

  • Cholecalciferol significantly increased 25-OHD levels to a median of 155 nmol/L.
  • Non-HD patients experienced increased 1,25-diOHD and decreased PTH.
  • Increased serum calcium and FGF-23 were observed in supplemented patients.

Conclusions:

  • Weekly cholecalciferol effectively replenishes 25-OHD in CKD patients.
  • Favorable effects on 1,25-diOHD and PTH were noted in non-HD patients.
  • Monitoring for hypercalcemia is crucial; no significant pleiotropic effects were identified.
Abstract

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