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Effect of cholecalciferol replacement on vascular calcification and left ventricular mass index in dialysis patients
Veysel Kidir1, Ibrahim Ersoy, Atila Altuntas
1Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Suleyman Demirel University , Isparta , Turkey .
Insights
Oral cholecalciferol treatment in dialysis patients with vitamin D insufficiency showed a lesser increase in left ventricular mass and improved diastolic functions. This study highlights potential cardiac benefits of vitamin D supplementation in this population.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Dialysis patients often have vitamin D insufficiency, which is linked to cardiovascular complications.
- Vascular calcification and left ventricular hypertrophy are common in patients undergoing dialysis.
Purpose of the Study:
- To investigate the impact of oral cholecalciferol on vascular calcification, left ventricular mass index (LVMI), and cardiac function in dialysis patients.
- To assess changes in biochemical markers and cardiac parameters after six months of treatment.
Main Methods:
- A six-month randomized controlled trial involving dialysis patients with vitamin D insufficiency.
- Treatment group received oral cholecalciferol; control group received standard therapy.
- Vascular calcification score (VCS), LVMI, and echocardiographic measurements were assessed at baseline and after six months.
Main Results:
- No significant change in LVMI or VCS was observed within the cholecalciferol group.
- The cholecalciferol group showed a significantly lower LVMI compared to the standard therapy group at six months.
- Improvements in left ventricular diastolic and left atrial diameters were noted in the cholecalciferol group, alongside increased 25-hydroxyvitamin D and albumin, and decreased C-reactive protein.
Conclusions:
- Six months of oral cholecalciferol treatment in dialysis patients led to a lesser increase in left ventricular mass.
- Improved diastolic function was observed in the cholecalciferol treatment group.
- Vitamin D supplementation may offer cardiovascular benefits for dialysis patients with vitamin D insufficiency.
Objective:
The aim of this study was to determine the effect of oral cholecalciferol treatment on vascular calcification, left ventricular mass index (LVMI) and other cardiac functions in dialysis patients.
Design And Methods:
A six-month course of oral cholecalciferol treatment was recommended to dialysis patients with vitamin D insufficiency. While 26 patients were given cholecalciferol treatment, 17 patients who could not tolerate to therapy received standard therapy. Initial biochemical parameters were measured, and they were measured again after 6 months of treatment. Echocardiographic measurements were also performed, and the vascular calcification score (VCS) was calculated at baseline and at the 6th month.
Results:
The cholecalciferol replacement group showed no significant change in LVMI and VCS values (p > 0.05). However, while LVMI was similar between groups at initial evaluation, it was lower in the cholecalciferol group at the 6th month when compared to the standard treatment group (141.8 ± 40.2 g/m(2) vs. 166.3 ± 31.4 g/m(2); p = 0.04). Likewise, left ventricular diastolic diameters (48.8 ± 5.1 mm vs. 47.5 ± 4.6 mm; p = 0.023) and left atrial diameters (41.2 ± 8.9 mm vs. 38.9 ± 8.1 mm; p = 0.006) decreased in the cholecalciferol group. Additionally, significant increases were observed in serum 25-hydroxyvitamin D (25(OH)D) and albumin levels, with a significant decrease in serum C-reactive protein levels.
Conclusion:
A lesser increase in left ventricular mass and better diastolic functions was observed in dialysis patients after 6 months of cholecalciferol treatment.
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