Vitamin D Repletion May Reduce Darbepoetin Requirements

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LAS VEGAS—Vitamin D repletion in patients with end-stage renal disease maintains hemoglobin (Hb) levels and results in decreased requirement of darbepoetin alfa, data show.

In a study by researchers at the University of Illinois in Chicago, 98 ESRD patients with baseline levels of 25-hydroxyvitamin D (25(OH)D) below 30 ng/mL underwent vitamin D supplementation with ergocalciferol. Clinicians used dosing guidelines recommended by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative for stage 3 and 4 chronic kidney disease because dosing guidelines are not yet established for ESRD, the researchers noted.

Patients had a mean age of 57 years; 53% were male and 67% were African American.

Compliance with ergocalciferol treatment was 64%. Serum 25(OH)D levels increased significantly in the compliant group compared with non- or partially-compliant group). A significantly greater percentage of patients in the compliant group than the non- or partially-compliant group achieved 25(OH)D serum levels greater than 30 (36.5% vs. 17.1%), according to data presented at the National Kidney Foundation's Spring Clinical Meetings. The investigators observed no significant difference in Hb levels among the groups. Darbepoetin doses, however, decreased significantly in the compliant patients but did not change in the non-compliant or partially compliant group.

The researchers, led by Usasiri Srisakul, PharmD, concluded that vitamin D deficiency may contribute to ESA hyporesponsiveness and supplementation with ergocalciferol may decrease ESA doses significantly.

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