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Hemodialysis Patients May Benefit from Cholecalciferol Treatment Targeting High Level of 25(OH)D. | LitMetric

AI Article Synopsis

  • Vitamin D plays a role in Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD), particularly affecting secondary hyperparathyroidism in hemodialysis (HD) patients, and while cholecalciferol is recommended for vitamin D deficiency, its effects on CKD-MBD are not entirely clear.
  • An observational study involved 22 HD patients with vitamin D levels between 30-50 ng/mL receiving cholecalciferol to boost their levels above 75 ng/mL, comparing baseline biochemical markers with those at higher vitamin D levels.
  • The study found that 73% of participants achieved the target vitamin D level in about 7.5 weeks with a total dose of 525,000

Article Abstract

(1) : Vitamin D is implicated in the pathogenesis of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) in hemodialysis (HD) patients, including the development of secondary hyperparathyroidism (SHP). While cholecalciferol supplementation is recommended for vitamin D deficiency correction, its impact on CKD-MBD remains inconsistent. The aim of this observational prospective study was to assess the effect of cholecalciferol in achieving high-normal serum 25-hydroxycholecalciferol (25(OH)D > 75 ng/mL) levels and its impact on CKD-MBD biochemical markers, including 1,25-dihydroxycholecalciferol (1,25(OH)D) and parathormone (PTH) in HD patients. The study also evaluated the maintenance dosage required to sustain 25(OH)D levels within the 50-75 ng/mL range. (2) : A total of 22 HD patients with baseline 25(OH)D levels 30-50 ng/mL received cholecalciferol (70,000 IU/week) to achieve the target serum 25(OH)D > 75 ng/mL. Baseline data on calcium, phosphate, 1-84 PTH, 25(OH)D, and 1,25(OH)D serum levels were compared with the data when 25(OH)D > 75 ng/mL was targeted or when the highest 25(OH)D levels were noted. (3) : Cholecalciferol significantly improved vitamin D status in HD patients, with 73% reaching the target 25(OH)D level >75 ng/mL in a median time of 7.5 weeks, with a median total dose of 525,000 IU. This was associated with a significant rise in 1,25(OH)D, decrease in 1-84 PTH, and no significant effect on calcium and phosphate levels. The median maintenance dose of cholecalciferol was established at 30,000 IU/week. (4) : The findings support the use of cholecalciferol targeting high normal 25(OH)D levels to improve biochemical markers of CKD-MBD in HD patients.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11596388PMC
http://dx.doi.org/10.3390/medicina60111831DOI Listing

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