Vitamin D Improves Bone Health in CKD Patients
Cholecalciferol supplementation is associated with an improvement in vitamin D deficiency and decreased serum intact parathyroid hormone (iPTH) levels and bone turnover markers in patients with early stage chronic kidney disease (CKD), according to a recent study.
Active forms of vitamin D are recommended for the treatment of mineral bone disease among patients with CKD, because it is presumed that native forms of vitamin D would not undergo significant activation to calciotrol, which is the most active biological form of vitamin D.
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For the study, patients were randomly assigned to receive either 2 directly observed oral doses of 300,000 IU cholecalciferol (n = 58) or matching placebo (n = 59) at baseline and at 8 weeks.
Results indicated that the serum levels of 25-hydroxycholecalciferol (25(OH)D) and 1,25-dihydroxycholecalciferol (1,25(OH)2D) had increased in patients taking cholecalciferol but not in those taking placebo, with between-group differences in mean change of 23.40 ng/ml for patients taking cholecalciferol and 14.98 pg/ml for those taking placebo.
The researchers also found that iPTH levels had decreased in patients taking cholecalciferol, with a between-group difference in mean change of -100.73 pg/ml. Additionally, serum total alkaline phosphatase (SAP, -20.25 U/L), bone-specific alkaline phosphatase (BAP, -12.54 U/L) and serum C-terminal cross-linked collagen type I telopeptides (CTX-1, -0.21) had significantly declined in patients taking cholecalciferol.
Change in 25(OH)D was found to be significantly correlated with change in iPHT, change in 1,25(OH)2D, change in SAP, change in BAP, and change in CTX-1, according to correlation analysis.
“Cholecalciferol supplementation corrects vitamin D deficiency and is effective in lowering serum intact parathyroid hormone and bone turnover markers in early stages of CKD,” the researchers concluded.
—Christina Vogt
Reference:
Yadav AK, Kumar V, Kumar V, Banerjee D, Gupta KL, Jha V. The effect of vitamin D supplementation on bone metabolic markers in chronic kidney disease [Published online October 17, 2017]. J Bone Mineral Res. doi:10.1002/jbmr.3314.