title: Prevalence of 25-OH vitamin D deficiency in a population of hemodialysis patients and efficacy of an oral ergocalciferol supplementation regimen.
abstract: OBJECTIVE
  Optimal dosing regimens for 25-OH vitamin D (VitD) deficiency are unknown in hemodialysis (HD) patients. Our aim was to evaluate the efficacy of prescribing ergocalciferol supplementation based on KDOQI guidelines for chronic kidney disease (CKD) stages III-IV in HD patients.
  
  
  METHODS
  We conducted a retrospective study of 96 urban, predominately African-American HD patients at a single-center dialysis unit with VitD insufficiency or deficiency treated with ergocalciferol. Patients were classified as either compliant or non-compliant with supplementation as determined by review of pharmacy records. The primary outcome was VitD levels 6 months after initiation of treatment and secondary outcomes were VitD levels at 11 months, bone/mineral and anemia parameters.
  
  
  RESULTS
  The population was predominately African-American (69%) and Hispanic (28%). There were 61 individuals in the compliant group and 35 individuals in the non-compliant group. The compliant group was older but otherwise similar in demographics and co-morbid conditions to the non-compliant group. After 6 months of treatment, the compliant group had a significant increase in VitD level (14.7 ± 6.0 to 28.7 ± 10.0 ng/ml, p < 0.0001) compared to the non-compliant group (14.7 ± 5.5 to 14.8 ± 7.1 ng/ml, p = 0.95). There were no differences in the incidence of hypercalcemia between the two groups. Except for a decrease in phosphorus in the compliant group (5.6 ± 1.6 to 4.9 ± 1.7 mg/dl, p = 0.004), there were no significant difference in bone/mineral or anemia parameters including dosing of darbepoetin.
  
  
  CONCLUSIONS
  An ergocalciferol-prescribing strategy using the KDOQI guidelines for stage III-IV kidney disease in HD patients with VitD deficiency or insufficiency is inadequate to achieve repletion or maintenance of normal VitD levels.
authors.affiliation: Department of Medicine, University of Illinois Hospital and Health Sciences System, Chicago, Ill., USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Porter
authors.forename: Cheryl
authors.initials: C
authors.lastname: Gilmartin
authors.forename: Usasiri
authors.initials: U
authors.lastname: Srisakul
authors.forename: Jose
authors.initials: J
authors.lastname: Arruda
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Akkina
mesh_terms: D000328:Adult; D000368:Aged; D002112:Calcifediol / Q000172:deficiency*; D004872:Ergocalciferols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy*; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D004872:Ergocalciferols; D014815:Vitamins; D002112:Calcifediol