Effect of replenishment of vitamin D on survival in patients with decompensated liver cirrhosis: A prospective study

AIM To assess the vitamin D(VD) deficiency as a prognostic factor and effect of replenishment of VD on mortality in decompensated cirrhosis. METHODS Patients with decompensated liver cirrhosis were screened for serum VD levels. A total of 101 VD deficient patients(< 20 ng/mL) were randomly enrolled in two groups: Treatment group(n = 51) and control group(n = 50). Treatment group received VD treatment in the form of intramuscular cholecalciferol 300000 IU as loading dose and 800 IU/d oral as maintenance dose along with 1000 mg oral calcium supplementation. The VD level, clinical parameters and survival of both the groups were compared for 6-mo.RESULTS Prevalence of vitamin D deficiency(VDD) in decompensated CLD was 84.31%. The mean(SD) age of the patients in the treatment group(M:F: 40:11) and control group(M:F: 37:13) were 46.2(± 14.93) years and 43.28(± 12.53) years, respectively. Baseline mean(CI) VD(ng/mL) in control group and treatment group were 9.15(8.35-9.94) and 9.65(8.63-10.7), respectively. Mean(CI) serum VD level(ng/mL) at 6-mo in control group and treatment group were 9.02(6.88-11.17) and 29(23-35), respectively. Over the period of time the VD, calcium and phosphorus level was improved in treatment group compared to control group. There was nonsignificant trend seen in greater survival(69% vs 64%; P > 0.05) and longer survival(155 d vs 141 d; P > 0.05) in treatment group compared to control group. VD level had no significant association with mortality(P > 0.05). In multivariate analysis, treatment with VD supplement was found significantly(P < 0.05; adjusted hazard ratio: 0.48) associated with survival of the patients over 6-mo. CONCLUSION VD deficiency is very common in patients of decompensated CLD. Replenishment of VD may improve survival in patients with decompensated liver cirrhosis.