Prevalence of Vitamin D [25(OH)D] Deficiency and Effects of Supplementation With Ergocalciferol (Vitamin D2) in Stage 5 Chronic Kidney Disease Patients

Blair, Debra; Byham‐Gray, Laura; Lewis, Emily; McCaffrey, Susan

doi:10.1053/j.jrn.2008.04.008

Cited by 95 publications

(92 citation statements)

References 30 publications

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“…Low 25(OH)D levels have been associated with reduced HRQOL in CKD-5D (19), but an earlier study that assessed only the Short Form-36 physical component score reported no effect after 6 months of ergocalciferol supplementation (39). In this study, HRQOL scores using the KDQOL-36 did not change significantly with treatment allocation.…”

Section: Muscle Strength Functional Capacity and Hrqolcontrasting

confidence: 75%

Effects of Cholecalciferol on Functional, Biochemical, Vascular, and Quality of Life Outcomes in Hemodialysis Patients

Hewitt

O'Connor

O’Shaughnessy

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Observational studies suggest that calciferol supplementation may improve laboratory and patient-level outcomes of hemodialysis patients with reduced 25-hydroxyvitamin D [25(OH)D] levels. This randomized controlled trial examined effects of cholecalciferol supplementation in patients on hemodialysis.Design, setting, participants, & measurements Sixty patients with 25(OH)D levels #24 ng/ml (#60 nmol/L) were randomized to receive 50,000 IU oral cholecalciferol or placebo, once weekly for 8 weeks and then monthly for 4 months. At baseline (autumn 2011) and 6 months, testing evaluated muscle strength, functional capacity, laboratory parameters, pulse wave velocity (PWV), and health-related quality of life (HRQOL) using the Kidney Disease Quality of Life-36 survey.Results Patients were well matched by treatment allocation. Median age was 62 years (range, 20-86), 52% were women, 55% had a history of diabetes, and mean serum 25(OH)D was 1765 ng/ml (43613 nmol/L). Patients were assessed over 6 months by repeated-measures ANOVA. Patients allocated to cholecalciferol had significantly higher values of 25(OH)D (P,0.001), 1,25-dihydroxyvitamin D (P=0.04), and tartrate-resistant acid phosphatase-5b) (P=0.04) and a greater reduction in phosphorus values (P=0.03) than placebo-treated patients Values of serum calcium, intact parathyroid hormone, and episodes of hypercalcemia and hyperphosphatemia did not differ significantly between the groups. No significant differences were detected in muscle strength, functional capacity, PWV, or HRQOL.Conclusions In this randomized controlled trial, patients supplemented with cholecalciferol had higher 25(OH)D, 1,25-dihydroxyvitamin D, and tartrate-resistant acid phosphatase-5b levels, without increased calcium or phosphorus values. However, no effects were detected in muscle strength, functional capacity, PWV, or HRQOL.

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Section: Muscle Strength Functional Capacity and Hrqolcontrasting

confidence: 75%

Effects of Cholecalciferol on Functional, Biochemical, Vascular, and Quality of Life Outcomes in Hemodialysis Patients

Hewitt

O'Connor

O’Shaughnessy

et al. 2013

Clinical Journal of the American Society of Nephrology

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“…In recent years, several works have suggested that vitamin D deficiency could be one of the risk factors involved in the lack of response to EPO [4,9,10].…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Levels of 25-Hydroxy-Vitamin D and Degree of Anemia in Patients with Chronic Kidney Disease

López-Ramiro¹

2017

AJCEM

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Introduction: Vitamin D exercises pleiotropic effects independently of calcium and phosphorous homeostasis.Purpose: To analyze the possible correlation between levels of 25-hydroxy vitamin D (25(OH)D) and other parameters of patients with chronic kidney disease (CKD). Patients and methods: One hundred and forty-five patients with stage-5 CKD were studied (mean age 65.9 ± 14.6 years; 74 males and 71 females; Levels of 25(OH)D, age, bone alkaline phosphatase, procollagen I amino-terminal propeptide, carboxyterminal telopeptide of collagen I, intact parathyroid hormone (PTH), bio-PTH, hemoglobin, hematocrit, urea, creatinine, total proteins, albumin, iron, iron saturation index, calcium, phosphorous, total alkaline phosphatase, serum CO 2 , cholesterol, triglycerides, C-reactive protein, prealbumin, ferritin, proBNP, and fibroblast growth factor-23 (FGF-23) were determined. Spearman's correlation coefficient and p values were analyzed. Results: This work show a positive correlation between levels of 25(OH)D and anemia (i.e., hemoglobin, hematocrit, iron, iron saturation index, and ferritin). Conclusion: These results show the close relationship between the degree of anemia in patients with CKD and 25(OH)D levels. It is of great importance to maintain levels of 25(OH)D in patients with advanced-stage CKD, as this can decrease anemia levels and, in turn, lower quantities of erythropoietin would be necessary to maintain hematocrit.

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“…Although it may be argued that intervention time was too short, in a recent randomized trial providing oral cholecalciferol vs. placebo to haemodialysis patients, no difference in the frequency of falls was noted after 6 months 148. Similarly, only few small studies have addressed the effect of vitamin D on muscle metabolic pathways in renal population 149, 150. Whereas in general vitamin D does not seem to have any additional benefit on glucose homeostasis and insulin sensitivity,151 repletion with ergocalciferol may assist in improving glycaemic control in CKD patients 150…”

Section: Interventional Studies On Vitamin D For Improving Musculoskementioning

confidence: 99%

Vitamin D, a modulator of musculoskeletal health in chronic kidney disease

Molina

Carrero

Bover

et al. 2017

J cachexia sarcopenia muscle

102

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The spectrum of activity of vitamin D goes beyond calcium and bone homeostasis, and growing evidence suggests that vitamin D contributes to maintain musculoskeletal health in healthy subjects as well as in patients with chronic kidney disease (CKD), who display the combination of bone metabolism disorder, muscle wasting, and weakness. Here, we review how vitamin D represents a pathway in which bone and muscle may interact. In vitro studies have confirmed that the vitamin D receptor is present on muscle, describing the mechanisms whereby vitamin D directly affects skeletal muscle. These include genomic and non‐genomic (rapid) effects, regulating cellular differentiation and proliferation. Observational studies have shown that circulating 25‐hydroxyvitamin D levels correlate with the clinical symptoms and muscle morphological changes observed in CKD patients. Vitamin D deficiency has been linked to low bone formation rate and bone mineral density, with an increased risk of skeletal fractures. The impact of low vitamin D status on skeletal muscle may also affect muscle metabolic pathways, including its sensitivity to insulin. Although some interventional studies have shown that vitamin D may improve physical performance and protect against the development of histological and radiological signs of hyperparathyroidism, evidence is still insufficient to draw definitive conclusions.

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Prevalence of Vitamin D [25(OH)D] Deficiency and Effects of Supplementation With Ergocalciferol (Vitamin D2) in Stage 5 Chronic Kidney Disease Patients

Cited by 95 publications

References 30 publications

Effects of Cholecalciferol on Functional, Biochemical, Vascular, and Quality of Life Outcomes in Hemodialysis Patients

Effects of Cholecalciferol on Functional, Biochemical, Vascular, and Quality of Life Outcomes in Hemodialysis Patients

Correlation Between Levels of 25-Hydroxy-Vitamin D and Degree of Anemia in Patients with Chronic Kidney Disease

Vitamin D, a modulator of musculoskeletal health in chronic kidney disease

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