Ergocalciferol versus Cholecalciferol for Nutritional Vitamin D Replacement in CKD

被引:13
作者
Mangoo-Karim, Roberto [1 ,2 ]
Abreu, Juliana Da Silva [1 ]
Yanev, George P. [3 ]
Perez, Ninfa N. [1 ]
Stubbs, Jason R. [4 ]
Wetmore, James B. [5 ]
机构
[1] Gamma Med Res Inc, Edinburg, TX USA
[2] South Texas Kidney Specialists PA, Mcallen, TX USA
[3] Univ Texas Pan Amer, Dept Math, Edinburg, TX 78541 USA
[4] Univ Kansas, Med Ctr, Div Nephrol & Hypertens, Kansas City, KS 66103 USA
[5] Hennepin Cty Med Ctr, Div Nephrol, Minneapolis, MN 55415 USA
关键词
25-hydroxyvitamin D; Vitamin D; Cholecalciferol; Ergocalciferol; Mineral metabolism; Chronic kidney disease; CHRONIC KIDNEY-DISEASE; 3RD NATIONAL-HEALTH; PARATHYROID-HORMONE; 25-HYDROXYVITAMIN D; METABOLIC SYNDROME; SERUM-LEVELS; PREVALENCE; DEFICIENCY; CALCIUM; D-3;
D O I
10.1159/000430813
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background/Aims: Is cholecalciferol (D-3) superior to ergocalciferol (D-2) in treating nutritional vitamin D deficiency in chronic kidney disease (CKD)? The answer to this question has not been fully explored. Methods: A retrospective analysis of 57 patients with non-dialysis-requiring CKD was conducted to assess the relative effectiveness of D-2 versus D-3 replacement on circulating 25(OH) D levels. Levels of 25(OH) D were assessed at baseline, after attempted repletion with D-2, and then after attempted repletion with D-3. The relative paired differences of the drug treatment effects were tested using t-tests. Multiple regression modeling was used to determine the factors significantly associated with differential responsiveness to the drugs. Results: The mean (SEM) age was 66.4 +/- 1.4 and mean eGFR was 40.5 +/- 2.2 ml/min/1.73 m(2). The baseline 25(OH) D level was 15.3 +/- 0.8 ng/ml. After standardizing to 100,000 units of drug, increases after cholecalciferol (2.7 +/- 0.3 ng/ml) were more than twice as great as those from ergocalciferol (1.1 +/- 0.3 ng/ml) (p < 0.0001). A sensitivity analysis, which pooled the results of an additional 109 individuals treated with ergocalciferol alone, revealed similar findings (standardized change 2.7 +/- 0.3 vs. 1.6 +/- 0.3 ng/ml, p = 0.0025). Factors associated with a superior response to cholecalciferol were lower baseline 25(OH) D level at the start of therapy (p = 0.015) and the interaction of sex and age (p = 0.0048), with younger females tending to benefit relatively more from cholecalciferol than older males did. Conclusion: Cholecalciferol may be superior to ergocalciferol in treating nutritional vitamin D deficiency in nondialysis CKD. (C) 2015 S. Karger AG, Basel
引用
收藏
页码:99 / 104
页数:6
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