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Daily oral 25-hydroxycholecalciferol supplementation for vitamin D deficiency in haemodialysis patients: effects on mineral metabolism and bone markers
Background. Vitamin D deficiency is frequently observed in end-stage renal disease (ESRD) patients; however, the effects of vitamin D supplementation have rarely been reported. We aimed to assess the effects of daily 25(OH)D3 supplementation on mineral metabolism, bone markers and Kidney Disease Out...
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| Published in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2008-11, Vol.23 (11), p.3670-3676 |
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| creator | Jean, Guillaume Terrat, Jean-Claude Vanel, Thierry Hurot, Jean-Marc Lorriaux, Christie Mayor, Brice Chazot, Charles |
| description | Background. Vitamin D deficiency is frequently observed in end-stage renal disease (ESRD) patients; however, the effects of vitamin D supplementation have rarely been reported. We aimed to assess the effects of daily 25(OH)D3 supplementation on mineral metabolism, bone markers and Kidney Disease Outcomes Quality Initiative (KDOQI) targets in haemodialysis (HD) patients for a period of 6 months. Methods. HD patients were included in this study if their serum 25(OH)D level was |
| doi_str_mv | 10.1093/ndt/gfn339 |
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Vitamin D deficiency is frequently observed in end-stage renal disease (ESRD) patients; however, the effects of vitamin D supplementation have rarely been reported. We aimed to assess the effects of daily 25(OH)D3 supplementation on mineral metabolism, bone markers and Kidney Disease Outcomes Quality Initiative (KDOQI) targets in haemodialysis (HD) patients for a period of 6 months. Methods. HD patients were included in this study if their serum 25(OH)D level was <75 mmol/L. Oral 25(OH)D3 was administered daily at 10–30 μg/day based on the severity of the deficiency. Characteristics of the patients were compared from the baseline to 6 months on the basis of their response to 25(OH)D3 administration and the patients were divided into three groups. Patients who showed partial response [serum 25(OH)D <75 nmol/L] were placed in group 1, those who showed normal response [serum 25(OH)D ranging from 75 to 150 nmol/L] were placed in group 2 and those who showed excessive response [serum 25(OH)D >150 nmol/L] were placed in group 3. Results. Of the 253 HD patients, 225 (89%) showed vitamin D insufficiency or deficiency, 172 were included in the study and 149 patients completed the study. After 6 months of treatment [mean daily 25(OH)D3: 16 ± 5 μg/day], the serum 25(OH)D level increased (30 ± 19 to 126 ± 46 nmol/ L, P < 0.001), with 13% of patients in group 1, 57% in group 2 and 30% in group 3. The serum intact parathyroid hormone (iPTH) level decreased (235 ± 186 to 189 ± 137 pg/mL, P = 0.05), except in group 1. Bone alkaline phosphatase (BALP) showed a tendency to normalize (23 ± 16 to 18.3 ± 11 μg/L, P < 0.05), leading to a decrease in alfacalcidol administration from 66% to 43% (P < 0.05), except in group 1. The KDOQI targets achieved increased significantly for serum calcium (76% to 85%) and phosphate levels (66% to 77%) in all patients. The serum albumin level increased in all groups (34.6 ± 4 to 36.8 ± 4 g/L, P < 0.05), without any significant improvement in normalized protein catabolic rate (nPCR) or C-reactive proteins (CRP). Conclusion. With a daily dose ranging from 10 to 30 μg, daily oral 25(OH)D3 supplementation corrects most vitamin D deficiencies or insufficiencies in HD patients, without any evident toxicity. The main effects observed included correction of excessive bone turnover, despite less alfacalcidol administration, increase in serum albumin level and increase in the percentage of patients with serum calcium and phosphorus levels within the recommendation of the KDOQI guidelines.]]></description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfn339</identifier><identifier>PMID: 18579534</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>25-hydroxyvitamin D ; Administration, Oral ; Aged ; Aged, 80 and over ; Alkaline Phosphatase - metabolism ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Biomarkers - metabolism ; Bone and Bones - metabolism ; Bone Density Conservation Agents - therapeutic use ; bone markers ; Calcifediol - administration & dosage ; Calcifediol - therapeutic use ; Calcium - blood ; Dietary Supplements ; Dose-Response Relationship, Drug ; Emergency and intensive care: renal failure. Dialysis management ; Female ; General and cellular metabolism. Vitamins ; haemodialysis ; Humans ; Hydroxycholecalciferols - therapeutic use ; Intensive care medicine ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - therapy ; Male ; Medical sciences ; Middle Aged ; mineral metabolism ; Outcome Assessment (Health Care) ; Pharmacology. Drug treatments ; Phosphorus - blood ; Renal Dialysis ; Vitamin D - administration & dosage ; Vitamin D - therapeutic use ; vitamin D deficiency ; Vitamin D Deficiency - drug therapy ; Vitamin D Deficiency - metabolism</subject><ispartof>Nephrology, dialysis, transplantation, 2008-11, Vol.23 (11), p.3670-3676</ispartof><rights>Oxford University Press © The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2008</rights><rights>2008 INIST-CNRS</rights><rights>The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-cf4c42fef3f34bef0b665a7d4afdedff9699113c42cbbf78c06dd6c6b8f351a63</citedby><cites>FETCH-LOGICAL-c441t-cf4c42fef3f34bef0b665a7d4afdedff9699113c42cbbf78c06dd6c6b8f351a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20829925$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18579534$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jean, Guillaume</creatorcontrib><creatorcontrib>Terrat, Jean-Claude</creatorcontrib><creatorcontrib>Vanel, Thierry</creatorcontrib><creatorcontrib>Hurot, Jean-Marc</creatorcontrib><creatorcontrib>Lorriaux, Christie</creatorcontrib><creatorcontrib>Mayor, Brice</creatorcontrib><creatorcontrib>Chazot, Charles</creatorcontrib><title>Daily oral 25-hydroxycholecalciferol supplementation for vitamin D deficiency in haemodialysis patients: effects on mineral metabolism and bone markers</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><addtitle>Nephrol Dial Transplant</addtitle><description><![CDATA[Background. Vitamin D deficiency is frequently observed in end-stage renal disease (ESRD) patients; however, the effects of vitamin D supplementation have rarely been reported. We aimed to assess the effects of daily 25(OH)D3 supplementation on mineral metabolism, bone markers and Kidney Disease Outcomes Quality Initiative (KDOQI) targets in haemodialysis (HD) patients for a period of 6 months. Methods. HD patients were included in this study if their serum 25(OH)D level was <75 mmol/L. Oral 25(OH)D3 was administered daily at 10–30 μg/day based on the severity of the deficiency. Characteristics of the patients were compared from the baseline to 6 months on the basis of their response to 25(OH)D3 administration and the patients were divided into three groups. Patients who showed partial response [serum 25(OH)D <75 nmol/L] were placed in group 1, those who showed normal response [serum 25(OH)D ranging from 75 to 150 nmol/L] were placed in group 2 and those who showed excessive response [serum 25(OH)D >150 nmol/L] were placed in group 3. Results. Of the 253 HD patients, 225 (89%) showed vitamin D insufficiency or deficiency, 172 were included in the study and 149 patients completed the study. After 6 months of treatment [mean daily 25(OH)D3: 16 ± 5 μg/day], the serum 25(OH)D level increased (30 ± 19 to 126 ± 46 nmol/ L, P < 0.001), with 13% of patients in group 1, 57% in group 2 and 30% in group 3. The serum intact parathyroid hormone (iPTH) level decreased (235 ± 186 to 189 ± 137 pg/mL, P = 0.05), except in group 1. Bone alkaline phosphatase (BALP) showed a tendency to normalize (23 ± 16 to 18.3 ± 11 μg/L, P < 0.05), leading to a decrease in alfacalcidol administration from 66% to 43% (P < 0.05), except in group 1. The KDOQI targets achieved increased significantly for serum calcium (76% to 85%) and phosphate levels (66% to 77%) in all patients. The serum albumin level increased in all groups (34.6 ± 4 to 36.8 ± 4 g/L, P < 0.05), without any significant improvement in normalized protein catabolic rate (nPCR) or C-reactive proteins (CRP). Conclusion. With a daily dose ranging from 10 to 30 μg, daily oral 25(OH)D3 supplementation corrects most vitamin D deficiencies or insufficiencies in HD patients, without any evident toxicity. The main effects observed included correction of excessive bone turnover, despite less alfacalcidol administration, increase in serum albumin level and increase in the percentage of patients with serum calcium and phosphorus levels within the recommendation of the KDOQI guidelines.]]></description><subject>25-hydroxyvitamin D</subject><subject>Administration, Oral</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alkaline Phosphatase - metabolism</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - metabolism</subject><subject>Bone and Bones - metabolism</subject><subject>Bone Density Conservation Agents - therapeutic use</subject><subject>bone markers</subject><subject>Calcifediol - administration & dosage</subject><subject>Calcifediol - therapeutic use</subject><subject>Calcium - blood</subject><subject>Dietary Supplements</subject><subject>Dose-Response Relationship, Drug</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>General and cellular metabolism. Vitamins</subject><subject>haemodialysis</subject><subject>Humans</subject><subject>Hydroxycholecalciferols - therapeutic use</subject><subject>Intensive care medicine</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>mineral metabolism</subject><subject>Outcome Assessment (Health Care)</subject><subject>Pharmacology. Drug treatments</subject><subject>Phosphorus - blood</subject><subject>Renal Dialysis</subject><subject>Vitamin D - administration & dosage</subject><subject>Vitamin D - therapeutic use</subject><subject>vitamin D deficiency</subject><subject>Vitamin D Deficiency - drug therapy</subject><subject>Vitamin D Deficiency - metabolism</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNp90UFvFCEUB_CJ0di1evEDGGKiB5OxMAzM0JvZatekxoM1MV4IAw-XysAKM6bzSfy6stlNm3jwRAi_9x7wr6rnBL8lWNCzYKazHzZQKh5UK9JyXDe0Zw-rVTkkNWZYnFRPcr7BGIum6x5XJ6RnnWC0XVV_LpTzC4pJedSweruYFG8XvY0etPLaWUjRozzvdh5GCJOaXAzIxoR-u0mNLqALZMA67SDoBZX9VsEYjVN-yS6jXSkoZfkcgbWgp4xKeSmD_cARJjVE7_KIVDBoiAHQqNJPSPlp9cgqn-HZcT2tvn54f73e1FefLz-u313Vum3JVGvb6raxYKml7QAWD5wz1ZlWWQPGWsGFIIQWo4fBdr3G3Biu-dBbyoji9LR6fei7S_HXDHmSo8savFcB4pxlg1vW95wW-PIfeBPnFMrdZEN6wnrS7dGbA9Ip5pzAyl1y5UWLJFjus5IlK3nIquAXx47zMIK5p8dwCnh1BCqXMGxSQbt85xrcN0I07N7Feff_gfXBuTzB7Z0sHy55RzsmN9--y-tPXzb8UqxlS_8Ckcq9jg</recordid><startdate>20081101</startdate><enddate>20081101</enddate><creator>Jean, Guillaume</creator><creator>Terrat, Jean-Claude</creator><creator>Vanel, Thierry</creator><creator>Hurot, Jean-Marc</creator><creator>Lorriaux, Christie</creator><creator>Mayor, Brice</creator><creator>Chazot, Charles</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope></search><sort><creationdate>20081101</creationdate><title>Daily oral 25-hydroxycholecalciferol supplementation for vitamin D deficiency in haemodialysis patients: effects on mineral metabolism and bone markers</title><author>Jean, Guillaume ; Terrat, Jean-Claude ; Vanel, Thierry ; Hurot, Jean-Marc ; Lorriaux, Christie ; Mayor, Brice ; Chazot, Charles</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-cf4c42fef3f34bef0b665a7d4afdedff9699113c42cbbf78c06dd6c6b8f351a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>25-hydroxyvitamin D</topic><topic>Administration, Oral</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alkaline Phosphatase - metabolism</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - metabolism</topic><topic>Bone and Bones - metabolism</topic><topic>Bone Density Conservation Agents - therapeutic use</topic><topic>bone markers</topic><topic>Calcifediol - administration & dosage</topic><topic>Calcifediol - therapeutic use</topic><topic>Calcium - blood</topic><topic>Dietary Supplements</topic><topic>Dose-Response Relationship, Drug</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>General and cellular metabolism. Vitamins</topic><topic>haemodialysis</topic><topic>Humans</topic><topic>Hydroxycholecalciferols - therapeutic use</topic><topic>Intensive care medicine</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>mineral metabolism</topic><topic>Outcome Assessment (Health Care)</topic><topic>Pharmacology. Drug treatments</topic><topic>Phosphorus - blood</topic><topic>Renal Dialysis</topic><topic>Vitamin D - administration & dosage</topic><topic>Vitamin D - therapeutic use</topic><topic>vitamin D deficiency</topic><topic>Vitamin D Deficiency - drug therapy</topic><topic>Vitamin D Deficiency - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jean, Guillaume</creatorcontrib><creatorcontrib>Terrat, Jean-Claude</creatorcontrib><creatorcontrib>Vanel, Thierry</creatorcontrib><creatorcontrib>Hurot, Jean-Marc</creatorcontrib><creatorcontrib>Lorriaux, Christie</creatorcontrib><creatorcontrib>Mayor, Brice</creatorcontrib><creatorcontrib>Chazot, Charles</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jean, Guillaume</au><au>Terrat, Jean-Claude</au><au>Vanel, Thierry</au><au>Hurot, Jean-Marc</au><au>Lorriaux, Christie</au><au>Mayor, Brice</au><au>Chazot, Charles</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Daily oral 25-hydroxycholecalciferol supplementation for vitamin D deficiency in haemodialysis patients: effects on mineral metabolism and bone markers</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><stitle>Nephrol Dial Transplant</stitle><addtitle>Nephrol Dial Transplant</addtitle><date>2008-11-01</date><risdate>2008</risdate><volume>23</volume><issue>11</issue><spage>3670</spage><epage>3676</epage><pages>3670-3676</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract><![CDATA[Background. Vitamin D deficiency is frequently observed in end-stage renal disease (ESRD) patients; however, the effects of vitamin D supplementation have rarely been reported. We aimed to assess the effects of daily 25(OH)D3 supplementation on mineral metabolism, bone markers and Kidney Disease Outcomes Quality Initiative (KDOQI) targets in haemodialysis (HD) patients for a period of 6 months. Methods. HD patients were included in this study if their serum 25(OH)D level was <75 mmol/L. Oral 25(OH)D3 was administered daily at 10–30 μg/day based on the severity of the deficiency. Characteristics of the patients were compared from the baseline to 6 months on the basis of their response to 25(OH)D3 administration and the patients were divided into three groups. Patients who showed partial response [serum 25(OH)D <75 nmol/L] were placed in group 1, those who showed normal response [serum 25(OH)D ranging from 75 to 150 nmol/L] were placed in group 2 and those who showed excessive response [serum 25(OH)D >150 nmol/L] were placed in group 3. Results. Of the 253 HD patients, 225 (89%) showed vitamin D insufficiency or deficiency, 172 were included in the study and 149 patients completed the study. After 6 months of treatment [mean daily 25(OH)D3: 16 ± 5 μg/day], the serum 25(OH)D level increased (30 ± 19 to 126 ± 46 nmol/ L, P < 0.001), with 13% of patients in group 1, 57% in group 2 and 30% in group 3. The serum intact parathyroid hormone (iPTH) level decreased (235 ± 186 to 189 ± 137 pg/mL, P = 0.05), except in group 1. Bone alkaline phosphatase (BALP) showed a tendency to normalize (23 ± 16 to 18.3 ± 11 μg/L, P < 0.05), leading to a decrease in alfacalcidol administration from 66% to 43% (P < 0.05), except in group 1. The KDOQI targets achieved increased significantly for serum calcium (76% to 85%) and phosphate levels (66% to 77%) in all patients. The serum albumin level increased in all groups (34.6 ± 4 to 36.8 ± 4 g/L, P < 0.05), without any significant improvement in normalized protein catabolic rate (nPCR) or C-reactive proteins (CRP). Conclusion. With a daily dose ranging from 10 to 30 μg, daily oral 25(OH)D3 supplementation corrects most vitamin D deficiencies or insufficiencies in HD patients, without any evident toxicity. The main effects observed included correction of excessive bone turnover, despite less alfacalcidol administration, increase in serum albumin level and increase in the percentage of patients with serum calcium and phosphorus levels within the recommendation of the KDOQI guidelines.]]></abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>18579534</pmid><doi>10.1093/ndt/gfn339</doi><tpages>7</tpages></addata></record> |
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| ispartof | Nephrology, dialysis, transplantation, 2008-11, Vol.23 (11), p.3670-3676 |
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| subjects | 25-hydroxyvitamin D Administration, Oral Aged Aged, 80 and over Alkaline Phosphatase - metabolism Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Biomarkers - metabolism Bone and Bones - metabolism Bone Density Conservation Agents - therapeutic use bone markers Calcifediol - administration & dosage Calcifediol - therapeutic use Calcium - blood Dietary Supplements Dose-Response Relationship, Drug Emergency and intensive care: renal failure. Dialysis management Female General and cellular metabolism. Vitamins haemodialysis Humans Hydroxycholecalciferols - therapeutic use Intensive care medicine Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy Male Medical sciences Middle Aged mineral metabolism Outcome Assessment (Health Care) Pharmacology. Drug treatments Phosphorus - blood Renal Dialysis Vitamin D - administration & dosage Vitamin D - therapeutic use vitamin D deficiency Vitamin D Deficiency - drug therapy Vitamin D Deficiency - metabolism |
| title | Daily oral 25-hydroxycholecalciferol supplementation for vitamin D deficiency in haemodialysis patients: effects on mineral metabolism and bone markers |
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