25 hydroxy vitamin D is higher when a renal multivitamin is given with cholecalciferol at hemodialysis

摘要

Background and Objectives: Seventy six hemodialysis (HD) patients were used in a prospective randomized and clinical trial to determine if a multivitamin with vitamin D (cholecalciferol 12,000 IU/week) given during dialysis would improve the vitamin D status of hemodialysis subjects. Methods and Study Design: Subjects were randomly assigned to two groups: 37 subjects were in the renal multivitamin without vitamin D (MV) group and 39 subjects were in a multivitamin route with vitamin D (MVD) group (12,000 IU of cholecalciferol per week). All subjects were given 2 multivitamin tablets at their 3 HD sessions each week for 20 weeks. Serum 25(OH)D, calcium (Ca), and phosphorus (P) levels were evaluated. Results: At baseline, mean serum 25(OH)D were below adequate (<30 ng/mL) in the MV group (23.5+/-12.2 ng/mL) and in the MVD group (20.8+/-10.3 ng/mL). A significant increase was seen in serum 25(OH)D levels (37.7+/-11.4 ng/mL; p<0.001) in the MVD group after vitamin D supplementation with no rise in the MV group value (21.7+/-11.4 ng/mL; p=0.06). Prior to supplementation, 17.9% of patients in the MVD group had adequate serum 25(OH)D level and post supplementation 76.9% in the MVD group had adequate serum 25(OH)D. In the MV group, 18.9% subjects had adequate serum 25(OH)D levels at baseline with 18.9% having 25(OH)D >30 ng/mL at the end of the study. There were no significant differences in group values for serum Ca and P. Conclusion: The majority of HD subjects given a multivitamin with cholecalciferol at dialysis had improvement in their vitamin D status.