Tags

Type your tag names separated by a space and hit enter

Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D Deficiency: A Randomized Clinical Trial.
J Am Soc Nephrol. 2016 Jun; 27(6):1801-10.JA

Abstract

Locally produced 1,25-dihydroxyvitamin D3 may have pleiotropic effects outside of bone. Experimental and observational studies suggest that nutritional vitamin D may enhance erythropoiesis in settings of 25-hydroxy vitamin D (25(OH)D) deficiency. We conducted a double-blind, placebo-controlled, randomized clinical trial to assess the effects of supplementation with ergocalciferol on epoetin utilization and other secondary outcomes in patients on hemodialysis with serum 25(OH)D <30 ng/ml. In all, 276 patients were randomized to 6 months of ergocalciferol or placebo. Mean±SD serum 25(OH)D increased from 16.0±5.9 ng/ml at baseline to 39.2±14.9 ng/ml in the ergocalciferol arm and did not change (16.9±6.4 ng/ml and 17.5±7.4 ng/ml, respectively) in the placebo arm. There was no significant change in epoetin dose over 6 months in the ergocalciferol or placebo arms (geometric mean rate 0.98 [95% confidence interval (95% CI), 0.94 to 1.02] versus 0.99 [95% CI, 0.95 to 1.03], respectively) and no difference across arms (P=0.78). No change occurred in serum calcium, phosphorus, intact parathyroid hormone, or C-reactive protein levels, cinacalcet use, or phosphate binder or calcitriol dose in either study arm. Rates of all-cause, cardiovascular, and infection-related hospitalizations did not differ by study arm, although statistical power was limited for these outcomes. In conclusion, 6 months of supplementation with ergocalciferol increased serum 25(OH)D levels in patients on hemodialysis with vitamin D insufficiency or deficiency, but had no effect on epoetin utilization or secondary biochemical and clinical outcomes.

Authors+Show Affiliations

Division of Nephrology, and Tufts University School of Medicine, Boston, Massachusetts; dmiskulin@tuftsmedicalcenter.org.Dialysis Clinic Inc., Nashville, Tennessee;Tufts University School of Medicine, Boston, Massachusetts; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts;Kidney Associates of Kansas City, Kansas City, Missouri;Dialysis Clinic Inc., North Brunswick, New Jersey; and Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.Dialysis Clinic Inc., Nashville, Tennessee;Division of Nephrology, and Tufts University School of Medicine, Boston, Massachusetts;

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26677862

Citation

Miskulin, Dana C., et al. "Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D Deficiency: a Randomized Clinical Trial." Journal of the American Society of Nephrology : JASN, vol. 27, no. 6, 2016, pp. 1801-10.
Miskulin DC, Majchrzak K, Tighiouart H, et al. Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D Deficiency: A Randomized Clinical Trial. J Am Soc Nephrol. 2016;27(6):1801-10.
Miskulin, D. C., Majchrzak, K., Tighiouart, H., Muther, R. S., Kapoian, T., Johnson, D. S., & Weiner, D. E. (2016). Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D Deficiency: A Randomized Clinical Trial. Journal of the American Society of Nephrology : JASN, 27(6), 1801-10. https://doi.org/10.1681/ASN.2015040468
Miskulin DC, et al. Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D Deficiency: a Randomized Clinical Trial. J Am Soc Nephrol. 2016;27(6):1801-10. PubMed PMID: 26677862.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D Deficiency: A Randomized Clinical Trial. AU - Miskulin,Dana C, AU - Majchrzak,Karen, AU - Tighiouart,Hocine, AU - Muther,Richard S, AU - Kapoian,Toros, AU - Johnson,Doug S, AU - Weiner,Daniel E, Y1 - 2015/12/17/ PY - 2015/04/30/received PY - 2015/08/22/accepted PY - 2015/12/19/entrez PY - 2015/12/19/pubmed PY - 2017/5/26/medline KW - anemia KW - hyperparathyroidism KW - randomized controlled trials KW - vitamin D SP - 1801 EP - 10 JF - Journal of the American Society of Nephrology : JASN JO - J Am Soc Nephrol VL - 27 IS - 6 N2 - Locally produced 1,25-dihydroxyvitamin D3 may have pleiotropic effects outside of bone. Experimental and observational studies suggest that nutritional vitamin D may enhance erythropoiesis in settings of 25-hydroxy vitamin D (25(OH)D) deficiency. We conducted a double-blind, placebo-controlled, randomized clinical trial to assess the effects of supplementation with ergocalciferol on epoetin utilization and other secondary outcomes in patients on hemodialysis with serum 25(OH)D <30 ng/ml. In all, 276 patients were randomized to 6 months of ergocalciferol or placebo. Mean±SD serum 25(OH)D increased from 16.0±5.9 ng/ml at baseline to 39.2±14.9 ng/ml in the ergocalciferol arm and did not change (16.9±6.4 ng/ml and 17.5±7.4 ng/ml, respectively) in the placebo arm. There was no significant change in epoetin dose over 6 months in the ergocalciferol or placebo arms (geometric mean rate 0.98 [95% confidence interval (95% CI), 0.94 to 1.02] versus 0.99 [95% CI, 0.95 to 1.03], respectively) and no difference across arms (P=0.78). No change occurred in serum calcium, phosphorus, intact parathyroid hormone, or C-reactive protein levels, cinacalcet use, or phosphate binder or calcitriol dose in either study arm. Rates of all-cause, cardiovascular, and infection-related hospitalizations did not differ by study arm, although statistical power was limited for these outcomes. In conclusion, 6 months of supplementation with ergocalciferol increased serum 25(OH)D levels in patients on hemodialysis with vitamin D insufficiency or deficiency, but had no effect on epoetin utilization or secondary biochemical and clinical outcomes. SN - 1533-3450 UR - https://www.unboundmedicine.com/medline/citation/26677862/Ergocalciferol_Supplementation_in_Hemodialysis_Patients_With_Vitamin_D_Deficiency:_A_Randomized_Clinical_Trial_ L2 - https://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=26677862 DB - PRIME DP - Unbound Medicine ER -