Prevalence of Vitamin D Deficiency and Effects of Supplementation With Cholecalciferol in Patients With Chronic Kidney Disease
Journal of Renal Nutrition
Sun Moon Kim, MD, PhD∗,
Hyung Jin Choi, MD, PhD∗,
Jung Pyo Lee, MD, PhD†, ‡,
Dong Ki Kim, MD, PhD†,
Yun Kyu Oh, MD, PhD†, ‡,
Yon Su Kim, MD, PhD†,
Chun Soo Lim, MD, PhD†, ‡, Corresponding author contact information, E-mail the corresponding author
∗ Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
† Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
‡ Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
Objective: We aimed to evaluate the vitamin D status, the effect of cholecalciferol supplementation, and the factors associated with vitamin D restoration in nondialytic patients with chronic kidney disease (CKD).
Design: The present study was a prospective open-label trial.
Setting: This study took place at the Seoul National University Boramae Medical Center.
Subjects: Patients with nondialytic CKD (estimated glomerular filtration rate eGFR 10-59 mL/min per 1.73 m2) participated in this study.
Intervention: Vitamin D status in 210 CKD patients was assessed and the patients with vitamin D deficiency (<30 ng/mL) were administered cholecalciferol (1,000 IU/day) for 6 months.
Main Outcome Measure: The restoration rate of vitamin D deficiency at 3 and 6 months and the response-related factors were analyzed.
Results: The prevalence of vitamin D deficiency was
- 40.7% in CKD Stage 3,
- 61.5% in Stage 4, and
- 85.7% in Stage 5.
The subgroup with vitamin D deficiency had a greater proportion of patients with diabetes, lower eGFR, and higher proteinuria.
With the supplementation, 52 patients (76.5%) reached levels of 25-hydroxy vitamin D (25(OH)D) of 30 ng/mL or greater at 3 months, and the restoration of vitamin D was observed in 61 patients (89.7%) at 6 months. Lower levels of 25(OH)D and a higher amount of proteinuria at baseline were the factors associated with lower response to vitamin D supplementation.
Conclusion: Vitamin D deficiency rate was high in nondialytic CKD patients, and the proportion increased as renal function decreased. A higher amount of proteinuria was the independent risk factor of nonresponse with supplementation. Vitamin D was replenished in most patients with cholecalciferol supplementation without any significant adverse effects.
Seems unlikely. Kidney problems often result in worse ability to process vitamin D, so more is needed or a different form
- Overview Kidney and vitamin D
- 7100 IU (50000 weekly) restored vitamin D levels for those with Chronic Kidney Disease – July 2012
- Kidney patients need some form vitamin D – the question is, which form – July 2013
- Chronic kidney with low vitamin D: 90 percent of pediatric nephrologists now recommend more D – Feb 2013
- Standard and artificial vitamin D both help Chronic Kidney Disease – meta-analysis April 2013
- Kidney disease requires magnesium - Jan 2013
- 2000 IU vitamin D3 was not enough for children with chronic kidney disease – Feb 2013
- Kidney Dialysis clinics reluctant to add vitamin D treatment as they are not reimbursed – Oct 2012
- 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