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胆钙化醇对慢性肾脏病患者甲状旁腺激素及维生素D水平的影响

Effect of cholecalciferol on parathyroid hormone and vitamin D levels in chronic kidney disease.

作者信息

Basturk T, Unsal A, Ulas T

机构信息

Department of Nephrology, Bagcilar Research and Education Hospital, Istanbul, Turkey.

出版信息

Minerva Urol Nefrol. 2011 Dec;63(4):287-92.

PMID:21996984
Abstract

AIM

We aimed to determine the effect of a monthly oral vitamin D on the serum 25-hydroxyvitamin D levels and iPTH levels in patients with CKD.

METHODS

This was a prospective controlled trial of 48 patients with CKD stage 3-4. Patients were divided into two groups Group1 the cholecalciferol treatment group, Group 2, the control group. One patient in Group 1, and 3 patients in Group2 were excluded after the baseline 25(OH)D levels were determined to be greater than 30ng/ml. Two patients in Group1, and one patient in Group 2 were excluded after the baseline iPTH was determined to be less than 70 pg/ml and greater than 300 pg/ml. Five patients in both groups were lost to follow-up. Thus, a total of 16 patients in Group 1 and 15 patients in Group2 completed the three month study. Group1 patients received 300,000 IU month oral cholecalciferol.

RESULTS

The mean serum 25(OH)D concentration of the group1 was significantly higher at baseline (P=0.039). At the end of the three months; serum 25 (OH) D level increased significantly in Group1 (P=0.001). iPTH level of Group1 was significantly lower at baseline (P=0.034). The values of the group1 before and end of third month was compared, serum Ca (P=0.011), P (P=0.013) level showed significant increase, but no significant increase in the Group 2 (P>0.05). The groups had not a clinically significant change in serum Ca and P level (P>0.05).

CONCLUSION

Oral cholecalciferol supplementation can be used safely and effective in reducing iPTH levels and correcting vitamin D insufficiency/deficiency in patients with CKD.

摘要

目的

我们旨在确定每月口服维生素D对慢性肾脏病(CKD)患者血清25-羟维生素D水平和甲状旁腺激素(iPTH)水平的影响。

方法

这是一项针对48例3-4期CKD患者的前瞻性对照试验。患者被分为两组,第1组为胆钙化醇治疗组,第2组为对照组。在基线25(OH)D水平被确定大于30ng/ml后,第1组排除1例患者,第2组排除3例患者。在基线iPTH被确定小于70 pg/ml且大于300 pg/ml后,第1组排除2例患者,第2组排除1例患者。两组各有5例患者失访。因此,第1组共有16例患者,第2组共有15例患者完成了为期三个月的研究。第1组患者每月口服300,000 IU胆钙化醇。

结果

第1组的平均血清25(OH)D浓度在基线时显著更高(P = 0.039)。在三个月结束时,第1组的血清25(OH)D水平显著升高(P = 0.001)。第1组的iPTH水平在基线时显著更低(P = 0.034)。比较第1组第三个月开始和结束时的值,血清钙(P = 0.011)、磷(P = 0.013)水平显示显著升高,但第2组无显著升高(P>0.05)。两组血清钙和磷水平无临床显著变化(P>0.05)。

结论

口服补充胆钙化醇可安全有效地降低CKD患者的iPTH水平并纠正维生素D不足/缺乏。

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引用本文的文献

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Impact of vitamin D on chronic kidney diseases in non-dialysis patients: a meta-analysis of randomized controlled trials.维生素 D 对非透析患者慢性肾脏病的影响:一项随机对照试验的荟萃分析。
PLoS One. 2013 Apr 23;8(4):e61387. doi: 10.1371/journal.pone.0061387. Print 2013.
2
Vitamin D supplementation in pre-dialysis chronic kidney disease: A systematic review.透析前慢性肾脏病患者补充维生素D:一项系统评价
Dermatoendocrinol. 2012 Apr 1;4(2):118-27. doi: 10.4161/derm.20014.