%0 Journal Article
%T Oral Postdialysis Cholecalciferol Supplementation in Patients on Maintenance Hemodialysis: A Dose-Response Approach
%A Eric Descombes
%A Benoit Fellay
%A Ould Maouloud Hemett
%A Jean-Luc Magnin
%A Gilbert Fellay
%J International Journal of Nephrology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/597429
%X The aim of the present study was to evaluate the dose of postdialysis cholecalciferol needed to maintain the 25-hydroxyvitamin D [25(OH)D] levels in the optimal range of 75每150ˋnmol/L. Twenty-six patients who had low baseline 25(OH)D levels (mean ˋnmol/L) were studied. The 25(OH)D levels were measured every 2 months for one year. During the first two months, all the patients received 2000ˋIU of cholecalciferol after each hemodialysis (=6000ˋIU/wk). Thereafter, the dose was individualized and adapted every 2 months by administering 1 to 6 cholecalciferol tablets (2000ˋIU each) per week (total weekly dose = 2000每12000ˋIU/wk). During cholecalciferol supplementation, the 25(OH)D concentrations rapidly increased from baseline to ˋnmol/L at month 6 and ˋnmol/L at month 12. At month twelve, 86% of the patients had 25(OH)D levels within the target range with a mean dose of ˋIU/wk of cholecalciferol; however, the amount needed to maintain these levels varied widely from 0 ( ) to 12000ˋIU/wk ( ). In conclusion, postdialysis cholecalciferol prescription is quite effective in correcting vitamin D deficiency/insufficiency, but the amount of cholecalciferol needed to maintain the 25(OH)D levels within the optimal range over the long-term varies widely among patients and must be individualized. 1. Introduction Recent important advances have been made in understanding vitamin D physiology, beyond its classic role in mineral and bone metabolism [1每11]. Indeed, recent studies have shown that several tissues, in addition to the kidneys, express the enzyme CYP27B1, which catalyzes the 1 -hydroxylation of 25(OH)D, and that the vitamin D receptor (VDR) is expressed ubiquitously [1每11]. It is now known that a conversion of 25(OH)D to 1 ,25-dihydroxyvitamin D (calcitriol, the active form of vitamin D) occurs in several extrarenal cells and may be associated with significant biological roles beyond those traditionally attributed to vitamin D [1每11]. As a consequence, there has been a great deal of interest in the study of these nonclassical autocrine/intracrine effects of vitamin D during the past few years and a significant body of information in the medical literature has shown that vitamin D deficiency/insufficiency is associated with several abnormalities such as an increased risk of cardiovascular, musculoskeletal and autoimmune diseases, cancer, infections, diabetes, and mortality [1每6, 12每27]. As a result, the possible benefits of vitamin D supplementation in patients with low levels became the focus of interest of the scientific community and studies have even reported
%U http://www.hindawi.com/journals/ijn/2014/597429/