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Changes in serum 25-hydroxyvitamin D and plasma intact PTH levels following treatment with ergocalciferol in patients with CKD.
Am J Kidney Dis. 2007 Jul; 50(1):59-68.AJ

Abstract

BACKGROUND

Vitamin D insufficiency and deficiency are very common in patients with chronic kidney disease (CKD). The effect of ergocalciferol administration on serum 25-hydroxyvitamin D and plasma intact parathyroid hormone (PTH) levels in these patients is not known.

STUDY DESIGN

Retrospective study.

SETTING & PARTICIPANTS

Patients with CKD stage 3 or 4 who had a serum 25-hydroxyvitamin D level less than 30 ng/mL (<75 nmol/L) and increased plasma intact PTH level were treated with 50,000 IU of ergocalciferol once weekly for 12 weeks and once monthly thereafter for a total of 6 months. Patients were excluded if they had a history of active vitamin D sterol use.

OUTCOME & MEASUREMENTS

25-Hydroxyvitamin D and intact PTH were measured at baseline and follow-up.

RESULTS

66 patients met inclusion criteria. Average age was 70.4 +/- 1.3 (SE) years (range, 40 to 88 years), and 97% were men. There were 44 patients (66%) with CKD stage 3 and 22 patients (33%) with CKD stage 4. After a median follow-up of 6 months, there was a significant increase in 25-hydroxyvitamin D levels from 16.6 +/- 0.7 to 27.2 +/- 1.8 ng/mL (41 +/- 2 to 68 +/- 4 nmol/L; P < 0.05) and a significant decrease in plasma intact PTH levels from 231 +/- 26 to 192 +/- 25 pg/mL (ng/L; P < 0.05). A multivariate logistic regression model showed that an increase in 25-hydroxyvitamin D level greater than 5 ng/mL (>12 nmol/L) is associated with a significant likelihood of a greater than 30% decrease in plasma intact PTH level (odds ratio, 4.5; 95% confidence interval, 1.5 to 15.1; P < 0.05). Although posttreatment 25-hydroxyvitamin D levels were not different between patients with CKD stages 3 and 4, only patients with CKD stage 3 had a significant decrease in plasma intact PTH levels.

LIMITATIONS

This is a retrospective study with mostly male patients.

CONCLUSIONS

Results show that ergocalciferol administration has a favorable effect on PTH levels if therapy results in an increase in 25-hydroxyvitamin D levels; this effect is more evident in patients with CKD stage 3.

Authors+Show Affiliations

Division of Nephrology, Saint Louis Veterans Affairs Medical Center, St Louis, MO 63106, USA. ziyad.alaly@va.gov <ziyad.alaly@va.gov>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17591525

Citation

Al-Aly, Ziyad, et al. "Changes in Serum 25-hydroxyvitamin D and Plasma Intact PTH Levels Following Treatment With Ergocalciferol in Patients With CKD." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 50, no. 1, 2007, pp. 59-68.
Al-Aly Z, Qazi RA, González EA, et al. Changes in serum 25-hydroxyvitamin D and plasma intact PTH levels following treatment with ergocalciferol in patients with CKD. Am J Kidney Dis. 2007;50(1):59-68.
Al-Aly, Z., Qazi, R. A., González, E. A., Zeringue, A., & Martin, K. J. (2007). Changes in serum 25-hydroxyvitamin D and plasma intact PTH levels following treatment with ergocalciferol in patients with CKD. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 50(1), 59-68.
Al-Aly Z, et al. Changes in Serum 25-hydroxyvitamin D and Plasma Intact PTH Levels Following Treatment With Ergocalciferol in Patients With CKD. Am J Kidney Dis. 2007;50(1):59-68. PubMed PMID: 17591525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in serum 25-hydroxyvitamin D and plasma intact PTH levels following treatment with ergocalciferol in patients with CKD. AU - Al-Aly,Ziyad, AU - Qazi,Rizwan A, AU - González,Esther A, AU - Zeringue,Angelique, AU - Martin,Kevin J, PY - 2006/12/11/received PY - 2007/04/09/accepted PY - 2007/6/27/pubmed PY - 2007/6/29/medline PY - 2007/6/27/entrez SP - 59 EP - 68 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 50 IS - 1 N2 - BACKGROUND: Vitamin D insufficiency and deficiency are very common in patients with chronic kidney disease (CKD). The effect of ergocalciferol administration on serum 25-hydroxyvitamin D and plasma intact parathyroid hormone (PTH) levels in these patients is not known. STUDY DESIGN: Retrospective study. SETTING & PARTICIPANTS: Patients with CKD stage 3 or 4 who had a serum 25-hydroxyvitamin D level less than 30 ng/mL (<75 nmol/L) and increased plasma intact PTH level were treated with 50,000 IU of ergocalciferol once weekly for 12 weeks and once monthly thereafter for a total of 6 months. Patients were excluded if they had a history of active vitamin D sterol use. OUTCOME & MEASUREMENTS: 25-Hydroxyvitamin D and intact PTH were measured at baseline and follow-up. RESULTS: 66 patients met inclusion criteria. Average age was 70.4 +/- 1.3 (SE) years (range, 40 to 88 years), and 97% were men. There were 44 patients (66%) with CKD stage 3 and 22 patients (33%) with CKD stage 4. After a median follow-up of 6 months, there was a significant increase in 25-hydroxyvitamin D levels from 16.6 +/- 0.7 to 27.2 +/- 1.8 ng/mL (41 +/- 2 to 68 +/- 4 nmol/L; P < 0.05) and a significant decrease in plasma intact PTH levels from 231 +/- 26 to 192 +/- 25 pg/mL (ng/L; P < 0.05). A multivariate logistic regression model showed that an increase in 25-hydroxyvitamin D level greater than 5 ng/mL (>12 nmol/L) is associated with a significant likelihood of a greater than 30% decrease in plasma intact PTH level (odds ratio, 4.5; 95% confidence interval, 1.5 to 15.1; P < 0.05). Although posttreatment 25-hydroxyvitamin D levels were not different between patients with CKD stages 3 and 4, only patients with CKD stage 3 had a significant decrease in plasma intact PTH levels. LIMITATIONS: This is a retrospective study with mostly male patients. CONCLUSIONS: Results show that ergocalciferol administration has a favorable effect on PTH levels if therapy results in an increase in 25-hydroxyvitamin D levels; this effect is more evident in patients with CKD stage 3. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/17591525/Changes_in_serum_25_hydroxyvitamin_D_and_plasma_intact_PTH_levels_following_treatment_with_ergocalciferol_in_patients_with_CKD_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(07)00727-5 DB - PRIME DP - Unbound Medicine ER -