Changes in serum 25-hydroxyvitamin D and plasma intact PTH levels following treatment with ergocalciferol in patients with CKD.
BACKGROUND
Vitamin D insufficiency and deficiency are very common in patients with chronic kidney disease (CKD). The effect of ergocalciferol administration on serum 25-hydroxyvitamin D and plasma intact parathyroid hormone (PTH) levels in these patients is not known.


METHODS
Retrospective study.


METHODS
Patients with CKD stage 3 or 4 who had a serum 25-hydroxyvitamin D level less than 30 ng/mL (<75 nmol/L) and increased plasma intact PTH level were treated with 50,000 IU of ergocalciferol once weekly for 12 weeks and once monthly thereafter for a total of 6 months. Patients were excluded if they had a history of active vitamin D sterol use.


METHODS
25-Hydroxyvitamin D and intact PTH were measured at baseline and follow-up.


RESULTS
66 patients met inclusion criteria. Average age was 70.4 +/- 1.3 (SE) years (range, 40 to 88 years), and 97% were men. There were 44 patients (66%) with CKD stage 3 and 22 patients (33%) with CKD stage 4. After a median follow-up of 6 months, there was a significant increase in 25-hydroxyvitamin D levels from 16.6 +/- 0.7 to 27.2 +/- 1.8 ng/mL (41 +/- 2 to 68 +/- 4 nmol/L; P < 0.05) and a significant decrease in plasma intact PTH levels from 231 +/- 26 to 192 +/- 25 pg/mL (ng/L; P < 0.05). A multivariate logistic regression model showed that an increase in 25-hydroxyvitamin D level greater than 5 ng/mL (>12 nmol/L) is associated with a significant likelihood of a greater than 30% decrease in plasma intact PTH level (odds ratio, 4.5; 95% confidence interval, 1.5 to 15.1; P < 0.05). Although posttreatment 25-hydroxyvitamin D levels were not different between patients with CKD stages 3 and 4, only patients with CKD stage 3 had a significant decrease in plasma intact PTH levels.


CONCLUSIONS
This is a retrospective study with mostly male patients.


CONCLUSIONS
Results show that ergocalciferol administration has a favorable effect on PTH levels if therapy results in an increase in 25-hydroxyvitamin D levels; this effect is more evident in patients with CKD stage 3.
Al-Aly
Ziyad
Z
Division of Nephrology, Saint Louis Veterans Affairs Medical Center, St Louis, MO 63106, USA. ziyad.alaly@va.gov <ziyad.alaly@va.gov>
Qazi
Rizwan A
RA
González
Esther A
EA
Zeringue
Angelique
A
Martin
Kevin J
KJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004872:Ergocalciferols / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate; D006706:Homeostasis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D012189:Retrospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000188:drug therapy* / Q000209:etiology; D014815:Vitamins / Q000627:therapeutic use*
D004872:Ergocalciferols; D010281:Parathyroid Hormone; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D