Efficacy and safety of body weight-adapted oral cholecalciferol substitution in dialysis patients with vitamin D deficiency

摘要

Background Vitamin D deficiency is highly prevalent in dialysis patients. Whether substitution of native vitamin D in these patients is beneficial is a matter of ongoing discussion, as is the optimal dosing schedule. The purpose of this study was to investigate the efficacy and safety of a body-weight adapted oral dosing regimen of cholecalciferol in dialysis patients. Methods In a prospective single-center study 56 prevalent dialysis patients with a baseline 25OHD ₃ level 3 was measured at baseline and at study end, iPTH every three months, serum calcium and phosphorous monthly. Concurrent medication including phosphate binders, calcitriol and cinacalcet and dialysate calcium concentration remained unchanged throughout the study. Results Baseline 25OHD ₃ was 9.9?±?4.1?ng/mL and increased to 26.1?±?8.8?ng/mL (P?=?0.01). Fourteen patients (27?%) achieved a level >30?ng/mL and all others above 20?ng/mL. Cinacalcet therapy was positively associated with the increase in 25OHD ₃ (P?=?0.024). The plasma iPTH level significantly decreased from median 362?pg/mL to 297?pg/mL (P?=?0.01). This decline was more pronounced in patients with higher baseline iPTH levels (P? Conclusion The dosing regimen of oral cholecalciferol supplementation with 100?IU per kg body weight per week for 26?weeks in dialysis patients with vitamin D deficiency causes a significant increase in 25OHD ₃ close to the supposed target level of 30?ng/mL and a significant reduction in iPTH, without affecting serum calcium or phosphorous levels.