Vitamin D May Lower EPO Requirements

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Vitamin D May Lower EPO Requirements
Vitamin D May Lower EPO Requirements


ORLANDO, Fla.—Administration of ergocalciferol (vitamin D2) to anemic hemodialysis (HD) patients receiving erythropoietin (EPO) may decrease EPO requirements, data suggest.

Derek Larson, MD, and colleagues at Evanston Hospital, NorthShore University HealthSystem in Evanston, Ill., studied 86 HD patients, of whom 68 (78%) had 25-hydroxyvitamin D (25-D) levels below 30 ng/mL at baseline. These patients received 50,000 units of ergocalciferol weekly; patients with higher 25-D levels received 50,000 units monthly. Patients were followed with quarterly labs for nine months.

During the nine-month follow-up, 25-D levels increased significantly from an average of 23 to 36 ng/mL, according to findings presented at the National Kidney Foundation's 2010 Spring Clinical Meetings. The absolute change was an average of 12.2 ng/mL. The total EPO dose decreased significantly by an average of 95,063 units per month. The average hemoglobin (Hb) increased significantly by 0.86 g/dL from baseline to month 9. The researchers also observed no significant association between the change in 25-D levels and either Hb or total EPO dose.

Although the effect of ergocalciferol treatment on EPO requirement was not related directly to 25-D levels, further studies are needed to investigate the impact of 25-D repletion on anemia in patients with end-stage renal disease, the researchers concluded.

In a separate study presented at the conference, investigators at Kaiser Permanente Los Angeles Medical Center found that anemic HD patients deficient in 25-D who responded to ergocalciferol supplementation had no significant decrease in EPO requirements and no significant improvement in Hb levels compared with those who did not respond.
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