The effects of cholecalciferol treatment on mineral metabolism and inflammation markers in Turkish hemodialysis patients

Abstract

Objectives: To evaluate the effects of 25-hydroxycholecalciferol (25-[OH] D) on bone mineral metabolism and inflammation parameters in hemodialysis patients. Methods: The study was carried out at Hitit University Corum Education and Research Hospital, Corum, Turkey between July and September 2012. All of the 36 patients that underwent treatment in our hemodialysis unit were included in this study. Four patients were excluded from the study due to other complications. Of the remaining 32 patients, 28 patients (mean age; 52 ± 18 years; 15 males and 13 females) with a 25- (OH) vitamin D level of <30 ng/mL were included in the study. Four of the 32 remaining patients were excluded as their 25-(OH) vitamin D levels was >30 ng/ml. Patients with a 25-(OH) D level of <30 ng/mL were treated with 20,000 IU oral cholecalciferol once a week for 12 weeks. The level of vitamin D, mineral metabolism markers, and C-reactive protein (CRP) were evaluated. Results: After the treatment, the 25-(OH) D levels increased to >30 ng/mL in all patients (12.5±7.1 ng/mL versus 59.9±15.5 ng/mL; p<0.001). While there was a significant, but not life-threatening, increase in calcium levels (7.9 [7.26 to 8.32] mg/dL versus 8.48 [7.55 to 9.25] mg/dL, p<0.001), a statistically significant decrease was observed in CRP levels (9.34±4.4mg/L versus 4.4±1.6mg/L; p<0.001). Alkaline phosphatase, phosphorus, and parathyroid hormone levels did not change. Conclusion: Vitamin D deficiency is a common problem in HD patients. Short-term weekly cholecalciferol treatment is safe and effective in this patient group, and cholecalciferol treatment had a positive effect on inflammatory markers.