Daroux M, Shenouda M, Bacri JL, Lemaitre V, Vanhille P, Bataille P
Department of Nephrology, Doctor Duchenne Hospital, Boulogne-sur-Mer - France; and Department of Nephrology, Regional University Hospital of Lille, Lille - France.
Journal of Nephrology [2012:0]
Background: In patients with chronic kidney disease, vitamin D insufficiency is highly prevalent. It can be corrected by supplementation with either vitamin D2 or vitamin D3. Recent studies in patients without impaired kidney function suggest that vitamin D3 is more efficient than vitamin D2 in correcting vitamin D insufficiency. However, no direct comparison has been made in hemodialysis (HD) patients.
Methods: Thirty-nine HD patients with serum 25-hydroxyvitamin D (25(OH)D) levels =20 ng/mL were enrolled in this comparative, prospective pilot study.
They were divided into 3 groups and treated over a 3-month period.
Each patient received oral doses of 200,000 international units (IU) vitamin D per month according to the following treatment schedule:
- (i) vitamin D2 in small fractionated doses at each HD session, 3 times per week (group D2S);
- (ii) vitamin D2 once a month (group D2M); or
- (iii) vitamin D3 once a month (group D3M).
Changes in serum 25(OH)D levels were measured at the end of the study.
Results: Posttreatment serum 25(OH)D levels increased significantly in all groups.
The mean ± SD serum 25(OH)D value for group D3M patients (40 ± 13 ng/mL) was significantly higher than that for groups D2M (25 ± 9 ng/mL, p<0.01) and D2S patients (25 ± 9 ng/mL, p<0.01).
Serum 25(OH)D increased to levels >30 ng/mL in
- 84% of group D3M patients, but in only
- 15% and 27% of group D2M and D2S subjects, respectively.
Conclusion: Vitamin D3 is more effective than vitamin D2 in providing adequate 25(OH)D serum levels in HD patients.
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