EFFICACY OF DOUBLE DOSE VERSUS STANDARD DOSE ERGOCALCIFEROL ON VITAMIN D STATUS AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE
Background: Patients with chronic kidney disease (CKD) have an exceptionally high rate of 25-hydroxyvitamin D (25-OHD) deficiency. Modest supplementation with ergocalciferol to raise serum 25-OH-D levels might improve bone and mineral disorders in CKD. Limited evidence is available regarding dosage of ergocalciferol supplement in CKD populations.
Objectives: The study aimed to examine the effectiveness of double-dose ergocalciferol on serum 25-OHD, serum intact parathyroid hormone (PTH) levels and mineral and safety profiles compared with standard-dose ergocalciferol among CKD subjects.
Methods: The study employed a 12-week open labeled, randomized, controlled design among patients with CKD at stages III-IV and serum 25-OHD <30 ng/mL. Patients were randomized in 2 groups: standard dose treated with ergocalciferol as recommended by K/DOQI guidelines or double dose of ergocalciferol from recommendations. Serum testing including 25-OHD, intact PTH, phosphate and calcium was performed at baseline and week 12.
Results: Sixty-three patients were included [standard-dose group (N=30) and double-dose group (N=34)]. At the end of the 12 weeks, 20 (58.8%) patients in the double dose ergocalciferol group achieved sufficiency compared with 6 (20%) patients in the standard dose ergocalciferol group (p<0.05). A significant increase in serum 25-OHD levels (13.6±9.9 vs. 8.5±6.8 ng/mL, p=0.030) and decrease in serum PTH level group (-16.8±26.4 vs. -0.3±26.8 pg/mL, p=0.030) was found in the double-dose group compared with the standard-dose group. No adverse effect was associated with the treatment.
Conclusion: The study demonstrated that high dose oral ergocalciferol had higher efficacy to increase serum 25-OHD and decrease serum PTH levels among patients with CKD than standard-dose ergocalciferol after 12 weeks of treatment.
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