Nutritional vitamin D supplementation in dialysis: a randomized trial

Area of Science:

• Nephrology
• Endocrinology
• Nutritional Science

Background:

• Vitamin D deficiency is prevalent in patients starting long-term hemodialysis.
• The safety and efficacy of vitamin D supplementation in this population require further investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of oral ergocalciferol in increasing 25-hydroxyvitamin D (25[OH]D) levels in hemodialysis patients.
• To determine the optimal dosing regimen (weekly vs. monthly) for ergocalciferol supplementation.

Main Methods:

• A randomized, placebo-controlled, multicenter trial involving 105 hemodialysis patients with 25(OH)D levels ≤32 ng/ml.
• Participants received oral ergocalciferol (50,000 IU weekly or monthly) or placebo for 12 weeks.
• Primary endpoint: achieving vitamin D sufficiency (25[OH]D >32 ng/ml) at 12 weeks; secondary endpoint: survival assessed through 1 year.

Main Results:

• Vitamin D sufficiency was achieved in 91% (weekly), 66% (monthly), and 35% (placebo) of participants (P<0.001).
• Mean 25(OH)D levels significantly increased in both ergocalciferol groups compared to placebo.
• No significant differences in calcium, phosphate, or parathyroid hormone levels were observed between groups.

Conclusions:

• Oral ergocalciferol effectively increases 25(OH)D levels in incident hemodialysis patients.
• Supplementation is safe, with no significant adverse effects on calcium, phosphate, or parathyroid hormone levels within 12 weeks.