Changes in serum 25-hydroxyvitamin D and intact parathyroid hormone level following treatment with ergocalciferol among patients with chronic kidney disease
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Abstract
Background: Vitamin D insufficiency is highly prevalent among patients with CKD and contributes to secondary hyperparathyroidism. The observational data showed vitamin D deficiency was associated with increased bone turnover, decreased bone mineral density (BMD), increased cardiovascular problems and risk of mortality.
Methods: A prospective cohort study was conducted from January 2, 2019 to July 31, 2019 among patients with CKD stages 3 and 4 presenting vitamin D insufficiency in Pranangklao Hospital. Patients were treated with 40,000 units of ergocalciferol once weekly for 12 weeks.
Results: Of the 103 patients, 47 patients (46%) presented CKD stage 3 and 56 patients (54%) CKD stage 4. In the CKD stage 3 group; the average age was 69 years and 66% were men. In the CKD stage 4 group; the average age was 69 years and 44.6% were men. Following 12-week treatment, a significant increase was observed in 25-hydroxyvitamin D levels from 21.7 ± 5.1 to 28.0 ± 8.1 ng/mL in the CKD stage 3 group (p < 0.01) and decrease in PTH levels from 73.7 ± 35.3 to 68.2 ± 35.8 pg/mL. In the CKD stage 4 group the mean 25-hydroxyvitamin D levels significantly increased from 19.9 ± 6.9 to 27.9 ± 8.6 ng/mL (p < 0.01) and PTH levels decreased from 104.4 ± 58.4 to 98.8 ± 53.7 pg/mL. The mean eGFR, serum calcium and phosphate levels did not significantly change between baseline and 12-week treatment and between both groups.
Conclusion: Vitamin D supplementation among patients with CKD stages 3 and 4 presenting vitamin D insufficiency appears to improve 25-hydroxyvitamin D levels significantly while reducing PTH levels without changing serum calcium and phosphate levels.
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