title: Ergocalciferol decreases erythropoietin resistance in children with chronic kidney disease stage 5.
abstract: BACKGROUND
  Vitamin D insufficiency is related to erythropoietin resistance in chronic kidney disease (CKD). This study was conducted to evaluate the effect of ergocalciferol on the dose of erythrocyte-stimulating agent (ESA) administered to children with CKD stage 5 and vitamin D insufficiency.
  
  
  METHODS
  Twenty patients aged <18 years with CKD stages 5 or 5D and vitamin D insufficiency were divided into two groups. During the 12-week study, ten patients received oral ergocalciferol (treatment) whereas the other ten patients did not (control). The ESA dosage was recorded monthly.
  
  
  RESULTS
  There were no significant differences in demographic data, ESA dosages, and laboratory data, including corrected calcium, phosphorus, parathyroid hormone, hemoglobin, ferritin, 25-hydroxyvitamin D (25D), and transferrin saturation levels, between the two groups at baseline. At the completion of the study, serum 25D levels in the treatment group were significantly increased from baseline (p = 0.02) and were significantly higher than the serum 25D levels in the controls (p < 0.005). The ESA dosage in the treatment group was significantly decreased when compared to baseline (p = 0.04).
  
  
  CONCLUSIONS
  Vitamin D deficiency should be routinely detected and treated. Our results show that the administration of ergocalciferol in conjunction with 1,25-dihydroxyvitamin D3 reduced the dose of ESA required to treat children with CKD stages 5 and 5D and may decrease erythropoietin resistance.
authors: Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand. Pornpimol.R@chula.ac.th
authors: Pornpimol
authors: P
authors: Rianthavorn
authors: Pantipa
authors: P
authors: Boonyapapong
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000704:Analysis of Variance; D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D000068817:Epoetin Alfa; D004872:Ergocalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D012720:Severity of Illness Index; D013785:Thailand; D013997:Time Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D015415:Biomarkers; D004872:Ergocalciferols; D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D014807:Vitamin D; D000068817:Epoetin Alfa; C104450:25-hydroxyvitamin D