title: Effects of cholecalciferol on functional, biochemical, vascular, and quality of life outcomes in hemodialysis patients.
abstract: OBJECTIVE
  Observational studies suggest that calciferol supplementation may improve laboratory and patient-level outcomes of hemodialysis patients with reduced 25-hydroxyvitamin D [25(OH)D] levels. This randomized controlled trial examined effects of cholecalciferol supplementation in patients on hemodialysis.
  
  
  METHODS
  Sixty patients with 25(OH)D levels ≤24 ng/ml (≤60 nmol/L) were randomized to receive 50,000 IU oral cholecalciferol or placebo, once weekly for 8 weeks and then monthly for 4 months. At baseline (autumn 2011) and 6 months, testing evaluated muscle strength, functional capacity, laboratory parameters, pulse wave velocity (PWV), and health-related quality of life (HRQOL) using the Kidney Disease Quality of Life-36 survey.
  
  
  RESULTS
  Patients were well matched by treatment allocation. Median age was 62 years (range, 20-86), 52% were women, 55% had a history of diabetes, and mean serum 25(OH)D was 17±5 ng/ml (43±13 nmol/L). Patients were assessed over 6 months by repeated-measures ANOVA. Patients allocated to cholecalciferol had significantly higher values of 25(OH)D (P<0.001), 1,25-dihydroxyvitamin D (P=0.04), and tartrate-resistant acid phosphatase-5b) (P=0.04) and a greater reduction in phosphorus values (P=0.03) than placebo-treated patients Values of serum calcium, intact parathyroid hormone, and episodes of hypercalcemia and hyperphosphatemia did not differ significantly between the groups. No significant differences were detected in muscle strength, functional capacity, PWV, or HRQOL.
  
  
  CONCLUSIONS
  In this randomized controlled trial, patients supplemented with cholecalciferol had higher 25(OH)D, 1,25-dihydroxyvitamin D, and tartrate-resistant acid phosphatase-5b levels, without increased calcium or phosphorus values. However, no effects were detected in muscle strength, functional capacity, PWV, or HRQOL.
authors.affiliation: Postgraduate Medical School, University of Notre Dame, Sydney, Australia.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Hewitt
authors.forename: Alicia A
authors.initials: AA
authors.lastname: O'Connor
authors.forename: Denise V
authors.initials: DV
authors.lastname: O'Shaughnessy
authors.forename: Grahame J
authors.initials: GJ
authors.lastname: Elder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001696:Biomechanical Phenomena; D002762:Cholecalciferol / Q000627:therapeutic use*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006304:Health Status; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000187:drug effects; D009517:New South Wales; D063177:Pulse Wave Analysis; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000187:drug effects; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000187:drug effects*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D014815:Vitamins / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D