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Vitamin D plays an important role in the calcium and phosphate metabolism. Vitamin D promotes its intestinal absorption, it also enhances renal calcium reabsorption, and stimulates calcium and phosphate release from bone and into the bloodstream. These properties keep calcium and phosphorus levels within a narrow limit which is essential for bone mineralization, muscle contraction, nerve function and blood coagulation. Vitamin D also participates in the modulation of the immune system, cell differentiation and gene expression.
Vitamin D deficiency is common in patients on dialysis due to decreased synthesis and lack of activation in the kidneys; Both issues have a negative effect on bone health and the immune system. Weight-adjusted Vitamin D supplement customize the dose required for each patient.
Therapeutic intervention study (open label). 48 patients on chronic hemodialysis with 25(OH)D levels < 40ng/ml were included. Vitamin D levels were compared at the beginning and after 12 weeks after the administration of oral weight-adjusted cholecalciferol intake.
An increase in 25(OH)D was obtained in 43 (89.5%) patients, 53% presented 25(OH)D values greater than 40ng/dl. There were no significant changes in the levels of
Calcium, phosphorus and PTH.
Supplementation with oral cholecalciferol in a weight-adjusted dose can raise 25(OH)D levels in patients on chronic hemodialysis without significant alterations in Calcium, Phosphorus and PTH. The long-term benefits of this intervention are under evaluation.