Prevalence of vitamin D deficiency and effects of supplementation with cholecalciferol in patients with chronic kidney disease.
OBJECTIVE
We aimed to evaluate the vitamin D status, the effect of cholecalciferol supplementation, and the factors associated with vitamin D restoration in nondialytic patients with chronic kidney disease (CKD).


METHODS
The present study was a prospective open-label trial.


METHODS
This study took place at the Seoul National University Boramae Medical Center.


METHODS
Patients with nondialytic CKD (estimated glomerular filtration rate [eGFR] 10-59 mL/min per 1.73 m(2)) participated in this study.


METHODS
Vitamin D status in 210 CKD patients was assessed and the patients with vitamin D deficiency (<30 ng/mL) were administered cholecalciferol (1,000 IU/day) for 6 months.


METHODS
The restoration rate of vitamin D deficiency at 3 and 6 months and the response-related factors were analyzed.


RESULTS
The prevalence of vitamin D deficiency was 40.7% in CKD Stage 3, 61.5% in Stage 4, and 85.7% in Stage 5. The subgroup with vitamin D deficiency had a greater proportion of patients with diabetes, lower eGFR, and higher proteinuria. With the supplementation, 52 patients (76.5%) reached levels of 25-hydroxy vitamin D (25(OH)D) of 30 ng/mL or greater at 3 months, and the restoration of vitamin D was observed in 61 patients (89.7%) at 6 months. Lower levels of 25(OH)D and a higher amount of proteinuria at baseline were the factors associated with lower response to vitamin D supplementation.


CONCLUSIONS
Vitamin D deficiency rate was high in nondialytic CKD patients, and the proportion increased as renal function decreased. A higher amount of proteinuria was the independent risk factor of nonresponse with supplementation. Vitamin D was replenished in most patients with cholecalciferol supplementation without any significant adverse effects.
Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.
Sun Moon
SM
Kim
Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.
Hyung Jin
HJ
Choi
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Jung Pyo
JP
Lee
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Dong Ki
DK
Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Yun Kyu
YK
Oh
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yon Su
YS
Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. Electronic address: cslimjy@snu.ac.kr.
Chun Soo
CS
Lim
D000368:Aged; D002762:Cholecalciferol / Q000008:administration & dosage*; D019587:Dietary Supplements; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy*; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*
D014807:Vitamin D; D002762:Cholecalciferol