Trakarnvanich Thananda, Chalapipat Oran, Disthabanchong Sinee, Kurathong Sathit, Praditpornsilpa Kearkiat, Stitchantrakul Wasana, Chailurkit La-Or
Division of Nephrology, Department ofMedicine, BMA Medical college and Vajira Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2010 Aug;93(8):885-91.
To evaluate 25 hydroxyvitamin D (25-OH-D) deficiency in a cohort ofpredialysis CKD patients and the treatment effect and safety of high dose ergocalciferol supplement in predialysis CKD.
Fifty-six predialysis CKD patients who came for a regular visit at a single hospital with calculated glomerular filtration rate < or =60 mL/min/1.73 m2 were screened for 25-OH-D levels. Forty-four patients with 25-OH-D deficiency were recruited into this prospective observational study that examined the effect of high dose oral ergocalciferol supplementation. After eight weeks, 37 patients completed the follow-up and biochemical parameters were reevaluated and analyzed.
The mean 25-OH-D level of 56 patients was 25.6 +/- 8 ng/mL. Forty-four (78.5%) patients had 25-OH-D levels less than 30 ng/mL and four (7.1%) had severe deficiency with the level less than 15 ng/mL. High dose ergocalciferol supplement successively increased 25-OH-D levels in 35 (95%) patients. 25-OH-D levels increased significantly from 22 +/- 4.8 to 34.5 +/- 10.8 ng/mL after eight weeks (p < 0.001). During the study period, there were no changes in serum calcium, phosphate, and PTH. There was no other side effect associated with the treatment.
25-OH-D deficiency were found in this cohort of predialysis CKD patients. Ergocalciferol was a safe and effective supplement for the 25-OH-D in predialysis CKD.
评估一组透析前慢性肾脏病(CKD)患者的25羟维生素D(25-OH-D)缺乏情况,以及高剂量麦角钙化醇补充剂对透析前CKD患者的治疗效果和安全性。
在一家医院对56例估算肾小球滤过率≤60 mL/min/1.73 m²的定期前来就诊的透析前CKD患者进行25-OH-D水平筛查。44例25-OH-D缺乏患者被纳入这项前瞻性观察性研究,该研究检测了高剂量口服麦角钙化醇补充剂的效果。八周后,37例患者完成随访,对生化参数进行重新评估和分析。
56例患者的平均25-OH-D水平为25.6±8 ng/mL。44例(78.5%)患者的25-OH-D水平低于30 ng/mL,4例(7.1%)患者严重缺乏,水平低于15 ng/mL。高剂量麦角钙化醇补充剂使35例(95%)患者的25-OH-D水平相继升高。八周后,25-OH-D水平从22±4.8 ng/mL显著升高至34.5±10.8 ng/mL(p<0.001)。在研究期间,血清钙、磷和甲状旁腺激素(PTH)没有变化。治疗未出现其他副作用。
在这组透析前CKD患者中发现了25-OH-D缺乏情况。麦角钙化醇是透析前CKD患者补充25-OH-D的一种安全有效的补充剂。