Document Detail


Ergocalciferol treatment and aspects of mineral homeostasis in patients with chronic kidney disease stage 4-5.
MedLine Citation:
PMID:  23281842     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Focus on non-classical effects and possible less side effects of treatment with nutritional vitamin D, raises the expectation of possible benefits from treating chronic kidney disease (CKD) patients with ergocalciferol (vitamin D2). Treatment with 1,25(OH)2 vitamin D (calcitriol) induces elevated fibroblast growth factor 23 (FGF23), while epidemiological studies have found positive effects of nutritional and 25(OH)vitamin D on mortality in CKD. Disturbed mineral homeostasis in CKD is correlated to adverse outcome and cardiovascular mortality. The objective was to examine the possible effects of treatment with high doses of ergocalciferol on parameters of mineral homeostasis in predialysis CKD patients.
METHODS: A total of 43 adult patients with CKD stage 4-5, not receiving vitamin D supplementation, were studied, and allocated by simple randomization to either an intervention (n = 26) or a control group (n = 17). The intervention group received ergocalciferol, 50.000 IU/week for 6 weeks. Plasma FGF23, creatinine, parathyroid hormone (PTH), phosphate and ionized calcium were obtained at baseline and after the 6 weeks.
RESULTS: The intervention group had a significant increase in 25(OH)D2 concentration from < 10 to 90 ± 4 nmol/L, while 1,25(OH)2D (62 ± 6 at baseline and 67 ± 6 pmol/L at 6 weeks) remained stable. No changes were seen in the circulating vitamin D concentrations in the control group. After the 6 weeks of treatment no significant changes were seen in concentration of creatinine, phosphate, ionized calcium, PTH and FGF23 remained stable.
CONCLUSION: No harmful effects of short-term treatment with high-dose ergocalciferol were observed on markers of mineral homeostasis and FGF23 in CKD patients stage 4-5.
Authors:
Eva Gravesen; Jacob Hofman-Bang; Ewa Lewin; Klaus Olgaard
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2013-01-03
Journal Detail:
Title:  Scandinavian journal of clinical and laboratory investigation     Volume:  73     ISSN:  1502-7686     ISO Abbreviation:  Scand. J. Clin. Lab. Invest.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-11     Completed Date:  2013-08-21     Revised Date:  2013-11-14    
Medline Journal Info:
Nlm Unique ID:  0404375     Medline TA:  Scand J Clin Lab Invest     Country:  England    
Other Details:
Languages:  eng     Pagination:  107-16     Citation Subset:  IM    
Affiliation:
University of Copenhagen, Nephrological Department P, Rigshospitalet, Copenhagen, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bone and Bones / drug effects,  metabolism*
Calcium / blood
Creatinine / blood
Ergocalciferols / pharmacokinetics,  therapeutic use*
Female
Fibroblast Growth Factors / blood
Homeostasis
Humans
Male
Parathyroid Hormone / blood
Phosphates / blood
Renal Insufficiency, Chronic / blood,  drug therapy*,  mortality,  pathology
Treatment Outcome
Vitamins / pharmacokinetics,  therapeutic use*
Chemical
Reg. No./Substance:
0/Ergocalciferols; 0/Parathyroid Hormone; 0/Phosphates; 0/Vitamins; 0/fibroblast growth factor 23; 60-27-5/Creatinine; 62031-54-3/Fibroblast Growth Factors; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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