title: Nutritional vitamin D supplementation in haemodialysis: A potential vascular benefit?
abstract: OBJECTIVE
  Vitamin D deficiency is highly prevalent in end-stage renal disease and has been associated with atherosclerosis, endothelial dysfunction and left ventricular hypertrophy. Although activated vitamin D has shown to be cardioprotective, the cardiovascular benefits of nutritional vitamin D (i.e. ergocalciferol or cholecalciferol) have not been explored in the dialysis population. The aim of this investigation was to evaluate the effect of ergocalciferol therapy on vascular adhesion molecules, markers of inflammation and atherosclerosis among haemodialysis patients.
  
  
  METHODS
  This was a pilot study of matched haemodialysis patients. For every patient enrolled taking ergocalciferol, an age and race matched control was recruited. Predialysis blood samples were collected and assayed for adhesion molecules (soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), E-selectin and P-selectin), inflammatory cytokines (interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α)), oxLDL-β(2) GPI and IgG anticardiolipin.
  
  
  RESULTS
  A total of 40 haemodialysis patients were studied (20 on ergocalciferol therapy, 20 not receiving ergocalciferol therapy). Patients taking ergocalciferol had higher 25-hydroxyvitamin D levels compared with those not taking ergocalciferol. Even though doxercalciferol usage and dosing was similar between groups, plasma sVCAM-1, sICAM-1 and P-selectin concentrations were lower among ergocalciferol treated patients. No significant differences in E-selectin, IL-6, TNF-α, oxLDL-β(2) GPI or anticardiolipin antibody levels were observed.
  
  
  CONCLUSIONS
  Patients receiving ergocalciferol had lower plasma levels of vascular adhesion molecules despite equivalent use of activated vitamin D therapy. Future investigations should confirm the role of nutritional vitamin D therapy, in addition to activated D therapy, in haemodialysis patients and the potential vascular benefits of these agents.
authors.affiliation: Albany College of Pharmacy and Health Sciences, Albany             The Hortenese and Louis Rubin Dialysis Center, Inc., Clifton Park, New York, USA.
authors.forename: Magdalene M
authors.initials: MM
authors.lastname: Assimon
authors.forename: Page V
authors.initials: PV
authors.lastname: Salenger
authors.forename: Hassan A N
authors.initials: HA
authors.lastname: El-Fawal
authors.forename: Darius L
authors.initials: DL
authors.lastname: Mason
mesh_terms: D000328:Adult; D000368:Aged; D019587:Dietary Supplements; D004872:Ergocalciferols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010865:Pilot Projects; D006435:Renal Dialysis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014815:Vitamins / Q000627:therapeutic use*; D053482:beta 2-Glycoprotein I / Q000097:blood
chemical_list: D004872:Ergocalciferols; D015850:Interleukin-6; D008077:Lipoproteins, LDL; D019007:P-Selectin; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D014815:Vitamins; D053482:beta 2-Glycoprotein I; C099252:oxidized low density lipoprotein; D018799:Intercellular Adhesion Molecule-1