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