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Plasma exchange induces vitamin D deficiency
T F Hiemstra1, A Casian, P Boraks
1Divisions of Nephrology and Clinical Pharmacology, Department of Medicine, University of Cambridge, Box 118, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK. tfh24@cam.ac.uk.
QJM : Monthly Journal of the Association of Physicians
|October 18, 2013
Summary
Plasma exchange significantly lowers vitamin D binding protein (DBP) and vitamin D metabolites, including 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D. This procedure also causes a temporary drop in calcium levels.
Area of Science:
- Endocrinology
- Nephrology
- Immunology
Background:
- Plasma exchange is a therapeutic apheresis technique used for various medical conditions.
- Its non-specific nature can lead to the depletion of essential molecules and complications like hypocalcemia.
Purpose of the Study:
- To investigate the impact of plasma exchange on vitamin D binding protein (DBP) and its associated metabolites.
- To assess the changes in vitamin D levels and calcium concentrations following plasma exchange therapy.
Main Methods:
- A prospective cohort study involving 11 patients undergoing plasma exchange.
- Measurements of DBP and vitamin D metabolites were taken before, immediately after, and at 7 and 28 days post-treatment.
Main Results:
- Plasma exchange markedly reduced plasma DBP, 1,25-dihydroxyvitamin D, and 25-hydroxyvitamin D levels.
- A significant decrease in corrected calcium was observed immediately after treatment, correlating with 1,25-dihydroxyvitamin D levels.
- While DBP and 1,25-dihydroxyvitamin D normalized, 25-hydroxyvitamin D remained significantly lower up to 28 days post-exchange.
Conclusions:
- Plasma exchange causes an acute, reversible reduction in 1,25-dihydroxyvitamin D, DBP, and calcium.
- A sustained decrease in 25-hydroxyvitamin D levels is observed following plasma exchange.
- These findings highlight potential metabolic consequences of plasma exchange therapy.
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