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The effect of combined calcium and vitamin D3 supplementation on serum intact parathyroid hormone in moderate CKD.
Am J Kidney Dis 2009; 53(3):408-16AJ

Abstract

BACKGROUND

Studies addressing the effects of vitamin D(3) supplementation on secondary hyperparathyroidism in patients with moderate chronic kidney disease are scarce.

STUDY DESIGN

Post hoc analysis of the randomized clinical trial Vitamin D, Calcium, Lyon Study II (DECALYOS II) to assess effects according to baseline estimated glomerular filtration rate (eGFR).

SETTING & PARTICIPANTS

Multicenter, randomized, double-blinded, placebo-controlled study of 639 elderly women randomly assigned to calcium-vitamin D(3) fixed combination; calcium plus vitamin D(3) separate combination, or placebo.

INTERVENTIONS

Placebo or calcium (1,200 mg) and vitamin D(3) (800 IU) in fixed or separate combination.

OUTCOMES & MEASUREMENTS

Proportion of participants with a mean decrease in intact parathyroid hormone (iPTH) level of 30% or greater. eGFR was calculated using the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation and categorized as 60 or greater, 45 to 59, and less than 45 mL/min/1.73 m(2).

RESULTS

610 participants had an eGFR at baseline: 288 (47.2%), 222 (36.4%), and 100 (16.4%) were in each decreasing eGFR category. Across decreasing eGFR groups, 88%, 86%, and 89% had 25-hydroxyvitamin D (25[OH]D) levels less than 15 ng/mL at baseline. On treatment, similar improvements in the proportion of participants achieving 25(OH)D levels greater than 30 ng/mL at 6 months were seen in all kidney function groups (43%, 49%, and 41%, respectively). Active regimens versus placebo increased mean 25(OH)D levels from baseline in all eGFR groups at all times (P < 0.001 for all). The proportion with a 30% or greater decrease in iPTH level at 6 months was 50% in all eGFR groups on treatment versus 6% to 9% for placebo (P < 0.001 for all). The effects of the intervention on iPTH levels did not differ according to baseline eGFR (interaction P > 0.1 for all times).

LIMITATIONS

This study included only elderly white women.

CONCLUSION

Vitamin D(3) was effective in increasing 25(OH)D and decreasing iPTH levels in patients with moderate chronic kidney disease.

Authors+Show Affiliations

Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, CO 80262, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

19185400

Citation

Kooienga, Laura, et al. "The Effect of Combined Calcium and Vitamin D3 Supplementation On Serum Intact Parathyroid Hormone in Moderate CKD." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 53, no. 3, 2009, pp. 408-16.
Kooienga L, Fried L, Scragg R, et al. The effect of combined calcium and vitamin D3 supplementation on serum intact parathyroid hormone in moderate CKD. Am J Kidney Dis. 2009;53(3):408-16.
Kooienga, L., Fried, L., Scragg, R., Kendrick, J., Smits, G., & Chonchol, M. (2009). The effect of combined calcium and vitamin D3 supplementation on serum intact parathyroid hormone in moderate CKD. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 53(3), pp. 408-16. doi:10.1053/j.ajkd.2008.09.020.
Kooienga L, et al. The Effect of Combined Calcium and Vitamin D3 Supplementation On Serum Intact Parathyroid Hormone in Moderate CKD. Am J Kidney Dis. 2009;53(3):408-16. PubMed PMID: 19185400.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of combined calcium and vitamin D3 supplementation on serum intact parathyroid hormone in moderate CKD. AU - Kooienga,Laura, AU - Fried,Linda, AU - Scragg,Robert, AU - Kendrick,Jessica, AU - Smits,Gerard, AU - Chonchol,Michel, Y1 - 2009/01/29/ PY - 2008/04/09/received PY - 2008/09/04/accepted PY - 2009/2/3/entrez PY - 2009/2/3/pubmed PY - 2009/3/21/medline SP - 408 EP - 16 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 53 IS - 3 N2 - BACKGROUND: Studies addressing the effects of vitamin D(3) supplementation on secondary hyperparathyroidism in patients with moderate chronic kidney disease are scarce. STUDY DESIGN: Post hoc analysis of the randomized clinical trial Vitamin D, Calcium, Lyon Study II (DECALYOS II) to assess effects according to baseline estimated glomerular filtration rate (eGFR). SETTING & PARTICIPANTS: Multicenter, randomized, double-blinded, placebo-controlled study of 639 elderly women randomly assigned to calcium-vitamin D(3) fixed combination; calcium plus vitamin D(3) separate combination, or placebo. INTERVENTIONS: Placebo or calcium (1,200 mg) and vitamin D(3) (800 IU) in fixed or separate combination. OUTCOMES & MEASUREMENTS: Proportion of participants with a mean decrease in intact parathyroid hormone (iPTH) level of 30% or greater. eGFR was calculated using the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation and categorized as 60 or greater, 45 to 59, and less than 45 mL/min/1.73 m(2). RESULTS: 610 participants had an eGFR at baseline: 288 (47.2%), 222 (36.4%), and 100 (16.4%) were in each decreasing eGFR category. Across decreasing eGFR groups, 88%, 86%, and 89% had 25-hydroxyvitamin D (25[OH]D) levels less than 15 ng/mL at baseline. On treatment, similar improvements in the proportion of participants achieving 25(OH)D levels greater than 30 ng/mL at 6 months were seen in all kidney function groups (43%, 49%, and 41%, respectively). Active regimens versus placebo increased mean 25(OH)D levels from baseline in all eGFR groups at all times (P < 0.001 for all). The proportion with a 30% or greater decrease in iPTH level at 6 months was 50% in all eGFR groups on treatment versus 6% to 9% for placebo (P < 0.001 for all). The effects of the intervention on iPTH levels did not differ according to baseline eGFR (interaction P > 0.1 for all times). LIMITATIONS: This study included only elderly white women. CONCLUSION: Vitamin D(3) was effective in increasing 25(OH)D and decreasing iPTH levels in patients with moderate chronic kidney disease. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/19185400/The_effect_of_combined_calcium_and_vitamin_D3_supplementation_on_serum_intact_parathyroid_hormone_in_moderate_CKD_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(08)01568-0 DB - PRIME DP - Unbound Medicine ER -