This article is more than 5 years old. Information may no longer be current.
Cholecalciferol supplementation effectively treats vitamin D deficiency
Adults with stage 3 to 4 chronic kidney disease and vitamin D deficiency have improved serum 25-hydroxyvitamin D levels and decreased parathyroid hormone levels and bone turnover markers when treated with cholecalciferol supplementation, according to findings published in the Journal of Bone and Mineral Research.
Vivekanand Jha, MD, DM, PhD, FRCP, MBBS, professor of neurology at the University of Oxford in England and executive director of The George Institute for Global Health in New Delhi, and colleagues evaluated adults with stage 3 to 4 CKD randomly assigned to directly observed oral doses of 300,000 IU of cholecalciferol (n = 58; mean age, 43.17 years) or matching placebo (n = 59; mean age, 45.2 years) at baseline and 8 weeks. Researchers sought to assess the effect of oral cholecalciferol supplementation on markers of metabolism at 16 weeks.
The cholecalciferol group had increased serum 25-(OH)D levels at 16 weeks (P < .001) compared with no increase in the placebo group (P = .13); a difference was observed for changes in levels between the two groups (P < .001). Serum 1,25-(OH)2D levels also increased in the cholecalciferol group (P = .003), but not the placebo group (P = .85); the difference in change was significant between the two groups over 16 weeks (P = .007).
At 16 weeks, serum intact parathyroid hormone and total serum alkaline phosphatase, bone-specific alkaline phosphatase and serum C-terminal cross-linked collagen type 1 telopeptides (CTX-1) decreased in the cholecalciferol group and remained unchanged in the placebo group.
A decreasing trend in fibroblast growth factor 23 (FGF-23) was observed for the cholecalciferol group.
Correlations were observed between change in 25-(OH)D and changes in parathyroid hormone (P < .0001), 1,25-(OH)2D (P = .001), serum alkaline phosphatase (P = .002), bone-specific alkaline phosphatase (P = .004), CTX-1 (P = .023), inorganic phosphorus (P = .019) and calcium (P = .05).
“This study provides strong evidence that correction of native vitamin D deficiency with cholecalciferol supplementation sufficiently achieves sufficient level of 25-(OH)D in pre-dialysis CKD subjects and has a favorable effect on several biochemical parameters of CKD-[mineral and bone disorders], including suppression of secondary hypoparathyroidism, change in bone turnover markers and favorable trend in FGF-23 levels,” the researchers wrote. “Change in serum 25-(OH)D level significantly correlated with the change in markers of mineral metabolism, indicating that vitamin D deficiency is a potentially modifiable risk factor for bone mineral disease in subjects with stage G [3 to 4] CKD.” – by Amber Cox
Disclosures: The authors report no relevant financial disclosures.