Implementing Evidence-Based Vitamin D Protocol in the Dialysis Clinic: An Educational Approach
Nephrol Nurs J . May-Jun 2020;47(3):239-265.
Chigozie Uko 1 2 3, Rose Utley 4 5
Vitamin D deficiency is prevalent among patients with chronic kidney disease (CKD) and even more pronounced in patients with kidney failure who are undergoing peritoneal dialysis and hemodialysis. This project was a nurse practitioner-led quality improvement project conducted in an outpatient hemodialysis unit that focused on determining if educating providers and hemodialysis unit clinical staff on vitamin D guidelines increased the awareness and monitoring of patients on hemodialysis. The number of patients screened for vitamin D levels increased from 29% to 100%,
and 70% of patients tested were deficient in vitamin D. While the follow-up monitoring yielded a result of only 32%, we recommend processes and structures for long-term sustainability, such as periodic re-education, reminders and prompts for conducting needed follow-up, continued outcome monitoring, and champions to support the ongoing processes and structures.
- Kidney Dialysis often filters out Vitamin D, a problem for vegetarians and others- Feb 2021
- Kidney diseases and COVID-19 – probably helped by Vitamin D etc. – Jan 19, 2021
- Chronic Kidney Disease decreases Vitamin D in 4 ways – Nov 2017
- Vitamin D testers have different test results if there is chronic kidney disease – Sept 2019
- More than 30 ng of vitamin D is sometimes needed (Kidney needs 50 ng) – March 2019
- But many Kidney doctors only consider < 20 ng to be low and are unaware of the importance of fully-activited vitamin D during kidney failure
- Poor kidneys rarely get enough or the right form of vitamin D – Feb 2019
Kidney category starts with
Kidney category listing hassee also Overview Kidney and vitamin D
Search VitaminDWiki for dialysis OR haemodialysis 878 items not in PDF as of Aug 2020
Search VitaminDWiki for kidney transplant 798 items as of June 2019
"Chronic Kidney Disease" OR CKD 874 items as of Jan 2018
Kidney Intervention trials using Vitamin D:
- 1,000 IU of vitamin D provides little benefit (Kidney transplant in this case) – April 2021
- Kidney patients who happened to be getting high-dose Calcitriol were 9X less likely to die of COVID-19 - April 6, 2021
- Chronic Kidney Disease (stage 3) slowed by 30 ng of Vitamin D and Calcitriol – Dec 2019
- Diabetic nephropathy (Kidney) treated by 50,000 IU of vitamin D weekly – RCT Jan 2019
- Hemodialysis patients (CKD) helped by weekly 50,000 IU of vitamin D – Jan 2017
- Kidney disease helped by active or high dose Vitamin D - Feb 2014
- Peritoneal Dialysis nicely treated by active vitamin D – July 2013
- 7100 IU (50000 weekly) restored vitamin D levels for those with Chronic Kidney Disease – July 2012
- Chronic Kidney Disease reduced with 3600 IU vitamin D (50000 twice a month)– RCT Aug 2012
- Overview Kidney and vitamin D
Overview Kidney and vitamin D contains the following summary
- FACT: The Kidneys are not the primary way to activate vitamin D, the tissues are
- FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
- FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
- FACT: There are many on-going intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
- FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
- FACT: 38% of seniors have Chronic Kidney Disease and most are unaware of it CDC statistics 2020
- FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
- Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
Calcitriol - which bypasses the need for the kidney to activate vitamin D
Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012 - Category Kidney and Vitamin D contains
205 items Vitamin D is needed during Dialysis – initially only 29 pcnt tested, extensive education raised it to 32 pcnt – May 2020Printer Friendly PDF this page! Follow this page for updates192 visitors, last modified 28 Feb, 2021, This page is in the following categories (# of items in each category)