The Efficacy and Safety of High-Dose Cholecalciferol Therapy in Hemodialysis Patients
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Published:2024-02-06
Issue:2
Volume:12
Page:377
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ISSN:2227-9059
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Container-title:Biomedicines
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language:en
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Short-container-title:Biomedicines
Author:
Tarasewicz Agnieszka1ORCID, Komorniczak Michał1ORCID, Zakrzewska Agnieszka1, Biedunkiewicz Bogdan1, Małgorzewicz Sylwia2ORCID, Jankowska Magdalena1ORCID, Jasiulewicz Katarzyna1, Płonka Natalia1, Dąbrowska Małgorzata3, Dębska-Ślizień Alicja1ORCID, Tylicki Leszek1ORCID
Affiliation:
1. Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland 2. Department of Clinical Nutrition, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland 3. Central Clinical Laboratory, University Clinical Center, Smoluchowskiego 17, 80-214 Gdańsk, Poland
Abstract
Vitamin D deficiency and insufficiency are highly prevalent in CKD, affecting over 80% of hemodialysis (HD) patients and requiring therapeutic intervention. Nephrological societies suggest the administration of cholecalciferol according to the guidelines for the general population. The aim of the observational study was to evaluate the efficacy and safety of the therapy with a high dose of cholecalciferol in HD patients with 25(OH)D deficiency and insufficiency to reach the target serum 25(OH)D level > 30 ng/mL. A total of 22 patients (16 M), with an average age of 72.5 ± 13.03 years and 25(OH)D concentration of 13.05 (9.00–17.90) ng/mL, were administered cholecalciferol at a therapeutic dose of 70,000 IU/week (20,000 IU + 20,000 IU + 30,000 IU, immediately after each dialysis session). All patients achieved the target value > 30 ng/mL, with a mean time of 2.86 ± 1.87 weeks. In the first week, the target level of 25(OH)D (100%) was reached by 2 patients (9.09%), in the second week by 15 patients (68.18%), in the fourth week by 18 patients (81.18%), and in the ninth week by all 22 patients (100%). A significant increase in 1,25(OH)2D levels was observed during the study. However, only 2 patients (9.09%) achieved a concentration of 1,25(OH)2D above 25 ng/mL—the lower limit of the reference range. The intact PTH concentrations remained unchanged during the observation period. No episodes of hypercalcemia were detected, and one new episode of hyperphosphatemia was observed. In conclusion, our study showed that the administration of a high-therapeutic dose of cholecalciferol allowed for a quick, effective, and safe leveling of 25(OH)D concentration in HD patients.
Subject
General Biochemistry, Genetics and Molecular Biology,Medicine (miscellaneous)
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