[en] Background. The role of cholecalciferol supplementation
in end-stage renal disease (ESRD) patients has been questioned.
The objective of this randomized double-blinded
study is to assess whether cholecalciferol therapy can
increase serum 25-hydroxyvitamin D [25(OH)D] levels in
haemodialysed patients and the safety implications of this
therapy on certain biological parameters and vascular
calcifications score.
Methods. Forty-three haemodialysis patients were randomized
to receive placebo or cholecalciferol (25 000 IU)
therapy every 2 weeks. The biological parameters, serum
calcium, phosphorus, 25(OH)D and parathormone (PTH)
levels, were monitored monthly for 12 consecutive
months. Vascular calcifications were assessed by lateral
X-ray radiography.
Results. At baseline, the mean serum 25(OH)D levels
were low and similar in both groups. Thirty patients (16
treated and 14 placebo) completed the study: 11 patients
died (5 placebo and 6 treated), 1 patient dropped out and
1 patient was transplanted (both from the placebo group).
After 1 year, the percentage of 25(OH)D deficient patients
was significantly lower in the treated group. None of the
patients developed hypercalcaemia. The PTH levels
tended to increase over the study period under placebo
and to decrease in the cholecalciferol group. The median
changes in PTH levels from baseline to 1 year were statistically
different between the two groups [+80 (−58 to
153) and −115 (−192 to 81) under placebo and cholecalciferol
treatment, respectively, P = 0.02].The calcification
scores increased equivalently in both groups (+2.3 per
year).
Conclusions. Cholecalciferol is effective and safe, and
does not negatively affect calcium, phosphorus, PTH
levels and vascular calcifications. Additional studies are
needed to compare the impacts of nutritional and active
vitamin D agents on vascular calcification and mortality.
Disciplines :
Laboratory medicine & medical technology
Author, co-author :
DELANAYE, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
WEEKERS, Laurent ; Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
WARLING, Xavier
MOONEN, Martial
Smelten, Nicole ; Université de Liège - ULiège > Département des sciences cliniques > Néphrologie
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