Cholecalciferol supplementation in chronic kidney disease: restoration of vitamin D status and impact on parathyroid hormone.
OBJECTIVE
Hypovitaminosis D is highly prevalent among patients with chronic kidney disease (CKD) and has been associated with poor outcome. We aimed to test the effect of a protocol of cholecalciferol supplementation on the restoration of vitamin D status and on parathyroid hormone (PTH) levels in patients with CKD.


METHODS
This was a prospective interventional study of 6 months. Forty-five CKD patients (stages 3 and 4) with 25-hydroxyvitamin D deficiency [25(OH)D <15 ng/ml] were included. Patients received a weekly dose of 50,000 IU of cholecalciferol during 3 months, and 50,000 IU/month thereafter for those who had achieved 25(OH)D ≥30 ng/ml.


RESULTS
At 3 months, 78% of the patients restored their vitamin D status. At 6 months, only 43% of those patients maintained adequate vitamin D status. PTH decreased at 3 months (p = 0.02) but returned to baseline levels after 6 months. Fibroblast growth factor 23 increased at 3 months (p = 0.001) and returned to initial levels at 6 months. No changes were found in serum 1,25(OH)(2)D, ionized calcium and phosphorus.


CONCLUSIONS
A weekly dose of 50,000 IU of cholecalciferol for 3 months restored the vitamin D status of most patients and led to a reduction in PTH. The monthly dose of 50,000 IU appears not to be sufficient to maintain the levels of 25(OH)D.
Nutrition Program, Federal University of São Paulo, São Paulo, Brazil.
Miriam G
MG
Garcia-Lopes
Roberta
R
Pillar
Maria Ayako
MA
Kamimura
Lillian A
LA
Rocha
Maria Eugênia F
ME
Canziani
Aluízio B
AB
Carvalho
Lilian
L
Cuppari
D000328:Adult; D000368:Aged; D001823:Body Composition; D001938:Brazil / Q000453:epidemiology; D002118:Calcium / Q000097:blood; D002762:Cholecalciferol / Q000008:administration & dosage*; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010281:Parathyroid Hormone / Q000097:blood*; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology
D010281:Parathyroid Hormone; D014807:Vitamin D; D002762:Cholecalciferol; D010758:Phosphorus; D002118:Calcium