Cholecalciferol Supplementation in Chronic Kidney Disease: Restoration of Vitamin D Status and Impact on Parathyroid Hormone
Ann Nutr Metab 2012;61:74-82 (DOI: 10.1159/000339618)
Miriam G. Garcia-Lopesa, Roberta Pillarb, Maria Ayako Kamimuraa, b, Lillian A. Rochab, Maria Eugênia F. Canzianib, Aluízio B. Carvalhob, Lilian Cupparia, b
A Nutrition Program and
B Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
Background/Aims: Hypovitaminosis D is highly prevalent among patients with chronic kidney disease (CKD) and has been associated with poor outcome. We aimed to test the effect of a protocol of cholecalciferol supplementation on the restoration of vitamin D status and on parathyroid hormone (PTH) levels in patients with CKD.
Methods: This was a prospective interventional study of 6 months. Forty-five CKD patients (stages 3 and 4) with 25-hydroxyvitamin D deficiency [25(OH)D <15 ng/ml] were included. Patients received a weekly dose of 50,000 IU of cholecalciferol during 3 months, and 50,000 IU/month thereafter for those who had achieved 25(OH)D ?30 ng/ml.
Results: At 3 months, 78% of the patients restored their vitamin D status. At 6 months, only 43% of those patients maintained adequate vitamin D status. PTH decreased at 3 months (p = 0.02) but returned to baseline levels after 6 months. Fibroblast growth factor 23 increased at 3 months (p = 0.001) and returned to initial levels at 6 months. No changes were found in serum 1,25(OH)2D, ionized calcium and phosphorus.
Conclusions: A weekly dose of 50,000 IU of cholecalciferol for 3 months restored the vitamin D status of most patients and led to a reduction in PTH. The monthly dose of 50,000 IU appears not to be sufficient to maintain the levels of 25(OH)D.
Copyright © 2012 S. Karger AG, Basel
Lilian Cuppari, Department of Medicine, Division of Nephrology
Federal University of São Paulo, Rua Pedro de Toledo 282
São Paulo, SP 04039-000 (Brazil), Tel. +55 11 5904 8499, E-Mail lcuppari at uol.com.br
Received: November 14, 2011, Accepted after revision: May 21, 2012, Published online: August 7, 2012
- Overview Kidney and vitamin D
- Adding Vitamin decreased kidney deaths by 4x – Dec 2010
It is amazing that such excellent results were buried in the paper. They were not in the title nor abstract.
This is the result of about 10 trials with about 5,000 kidney disease patients.
Note: some of the trials were terminated as they felt it morally wrong to not give vitamin D to all of the Kidney patients