LAUSR

Vitamin D deficiency is now considered a global problem in general population, but it seemed to be more prominent in chronic kidney disease (CKD) patients, especially those on regular hemodialysis. Being a key regulator in mineral metabolism, there’s also emerging evidences linking vitamin D deficiency with inflammation and oxidative stress, which are both recognized as constant threats to cardiovascular outcomes in hemodialysis patients. However, data is still limited regarding an exact treatment protocols or regimens for vitamin D supplementation in such category. A prospective, randomized trial was carried out to evaluate the effect of weekly versus, monthly oral cholecalciferol, on vitamin D (25(OH)D) levels, oxidative stress markers, inflammatory markers and secondary hyperparathyroidism in hemodialysis patients. Fifty eligible hemodialysis patients were randomly assigned to either Group A (Oral 50.000IU Cholecalciferol, once weekly) or Group B (Oral 200.000IU Cholecalciferol, once monthly), for 3 months. Serum levels of (25(OH)D), serum malondialdehyde (MDA), serum superoxide dismutase (SOD), serum high sensitive (hsCRP), calcium, phosphorus, and parathormone (PTH) levels, were all assessed at baseline and at the end of the study. Cholecalciferol significantly increased serum levels of 25(OH)D in both groups, with a higher significant increase (p = 0.003) in Group A vs. Group B. Only Group A had a significant decrease in both serum MDA and serum hsCRP levels (p <0.001), while it had a significant higher increase (p = 0.011) in serum SOD when compared to Group B. Regarding PTH levels, a significant higher change from baseline ( -30 pg/mL vs. -3 pg/mL) was noticed in Group A vs. Group B. However, neither calcium nor phosphorus levels had a significant difference in both groups. No side effects were reported from both study groups. Weekly (50.000 IU) oral cholecalciferol seems to be an effective safe option to replenish vitamin D levels in hemodialysis patients, with an ameliorating effect on oxidative stress, inflammation and PTH levels.