title: Weekly high-dose ergocalciferol to correct vitamin D deficiency/insufficiency in hemodialysis patients: a pilot trial.
abstract: Controversy exists on which vitamin D (D2 or D3) and which dosage scheme is the best to obtain and maintain adequate 25 OH D levels in dialysis patients safely. We tried to determine whether high-dose vitamin D2 supplementation could obtain optimal vitamin D status without inducing hypercalcemia. We studied 82 patients on dialysis not taking active vitamin D therapy and supplemented them with oral vitamin D2 72,000 IU/week for 12 weeks followed by 24,000 IU/week as maintenance therapy during 36 weeks. By week 12, serum 25(OH)D increased from 15.2 ± 5.4 to 42.5 ± 13.2 ng/mL (P < 0.01) at week 12 and remained optimal (34.7 ± 12.0); 84.8% of the patients reached values ≥30 ng/mL. iPTH and alkaline phosphatase did not change at 48 weeks compared with baseline, but bone alkaline phosphatase decreased significantly (54.3 ± 46.0 to 44.3 ± 25.0; P = 0.02). Uncorrected serum Ca increased significantly at the end of follow-up (9.03 ± 0.42 to 9.14 ± 0.62; P = 0.04); hypercalcemia was presented in two patients in the first control visit (week 12), in one patient in the second control (week 30), and in one patient in the third control (week 48). In 222 serum calcium determinations during follow-up, hypercalcemia was observed in only 1.8% of cases. This vitamin D2 oral regimen with initial high doses was safe and sufficient to obtain and maintain optimal serum 25(OH)D concentrations and prevent vitamin D insufficiency in chronic kidney disease patients on dialysis.
authors.affiliation: Department of Nephrology, Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina.
authors.forename: Elisa
authors.initials: E
authors.lastname: Del Valle
authors.forename: Armando L
authors.initials: AL
authors.lastname: Negri
authors.forename: Erich
authors.initials: E
authors.lastname: Fradinger
authors.forename: Manuel
authors.initials: M
authors.lastname: Canalis
authors.forename: Pablo
authors.initials: P
authors.lastname: Bevione
authors.forename: Maria
authors.initials: M
authors.lastname: Curcelegui
authors.forename: Marina
authors.initials: M
authors.lastname: Bravo
authors.forename: Marcelo
authors.initials: M
authors.lastname: Puddu
authors.forename: Alicia
authors.initials: A
authors.lastname: Marini
authors.forename: Jaime
authors.initials: J
authors.lastname: Ryba
authors.forename: Patricia
authors.initials: P
authors.lastname: Peri
authors.forename: Guillermo
authors.initials: G
authors.lastname: Rosa Diez
authors.forename: Luis
authors.initials: L
authors.lastname: Sintado
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gottlieb
mesh_terms: D004872:Ergocalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D006435:Renal Dialysis / Q000009:adverse effects*; D014808:Vitamin D Deficiency / Q000188:drug therapy*
chemical_list: D004872:Ergocalciferols
keywords: High-dose ergocalciferol; controlled trial; hemodialysis; vitamin D deficiency