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Abstract: SA-PO694

Efficacy of High versus Conventional Dose of Ergocalciferol Supplementation on Serum 25-Hydroxyvitamin D and Interleukin-6 Levels in Hemodialysis Patients with Vitamin D Deficiency

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Siricheepchaiyan, Wittaya, Phramongkutklao Hospital, Bangkok, Thailand
  • Tasanavipas, Pamila, Phramongkutklao Hospital, Bangkok, Thailand
  • Tangwonglert, Theerasak, Phramongkutklao Hospital, Bangkok, Thailand
  • Nata, Naowanit, Phramongkutklao Hospital, Bangkok, Thailand
  • Chaiprasert, Amnart, Phramongkutklao Hospital, Bangkok, Thailand
  • Supasyndh, Ouppatham, Phramongkutklao Hospital, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao Hospital, Bangkok, Thailand
Background

Vitamin D deficiency alters innate and adaptive immune function, which will increase inflammatory cytokines production. Long-term dialysis is chronic inflammatory state and it has high prevalence of vitamin D deficiency. Trials examining the efficacy, and dosage of ergocalciferol supplementation in end stage renal disease (ESRD) on hemodialysis have been limited.

Methods

A multicenter, randomized, controlled trial was conducted in ESRD on hemodialysis with serum 25-hydroxyvitamin D (25[OH]D) level < 30 ng/mL. The conventional-group (N=35) and the high-dose group (N=35) were treated with ergocalciferol according to the K/DOQI guidelines and double dosage of ergocalciferol from the recommendation for 8 weeks, respectively. The main outcomes were measured by serum 25[OH]D, IL-6, calcium, and phosphorus levels.

Results

At the end of 8-week, there was a statistically significantly greater increase of mean serum 25[OH]D levels in the high-dose group compared with the conventional-dose group (17.8 ng/mL [95%CI 15.8 to 19.7] vs. 9.2 ng/mL [95%CI 7.4 to 11.1], P<0.001) and the high-dose group had also higher achievement of vitamin D sufficiency (25[OH]D level >30 ng/mL) than the conventional-dose group (97.4% vs. 76.4%, P=0.012). A trend toward lower serum IL-6 levels in the high-dose group (-0.45 pg/mL [95%CI -3.57 to 2.68], P=0.772) and there was a statistically significance lower serum IL-6 levels in the subgroup who had baseline serum 25[OH]D levels < 20 ng/mL (-2.67 pg/mL [IQR -6.56 to -0.17], P=0.039). There were no differences between the two groups in changes in serum calcium, phosphorus levels, and adverse events.

Conclusion

Oral high-dose ergocalciferol supplementation has achieved higher vitamin D sufficiency than standard recommendation dose in ESRD patients on dialysis with vitamin D deficiency. It might also be benefit on reduction of the inflammatory cytokine in group of patients with baseline serum 25[OH]D levels < 20 ng/mL.