Table 3.
Ergocalciferol dosing regimes and associated changes in 25(OH)D and PTH in CKD stage 3–5
| Study, year | Type of study | N | Ergocalciferol dose (cumulative dose) | Treatment period | Baseline 25(OH)D (ng/mL) | EOS 25(OH) D (ng/mL) | 25(OH)D change (ng/mL) | Baseline PTH (pg/mL) | PTH change (pg/mL) |
|---|---|---|---|---|---|---|---|---|---|
| DeVille et al, 200688 | Prospective cohort | 26 CKD 3, 51 CKD 4, 8 CKD 5 | If 25(OH)D <16 ng/mL: 50,000 IU twice weekly for 8 weeks, followed by 800 IU/day If 25(OH)D 16–30 ng/mL: 50,000 IU monthly for 2 months, followed by 800 IU/day If 25(OH)D >30 ng/mL 800 IU daily |
90 days | 17 | 42 | 25 | 176 | Decrease (−27, p<0.05; significant only in CKD 4) |
| Zisman et al, 200786 | Prospective cohort | 24 CKD 3, 28 CKD 4 | If 25(OH)D <15 ng/mL: 50,000 IU weekly for 4 weeks, followed by 50,000 monthly for 3 months, followed by 1200 IU/daily If 25(OH)D 15–25 ng/mL: 50,000 IU weekly for 4 weeks, followed by 1,200 IU daily If 25(OH)D >25 ng/mL: 1200–2000 IU daily |
Mean 7.4 months (CKD 3) | 20.3 (CKD 3) | 31.6 (CKD 3) | 11.3 | 154 | Decrease (−24, p=0.04) |
| Mean 6.8 months (CKD 4) | 18.8 (CKD 4) | 35.4 (CKD 4) | 16.6 | 165 | Decrease (−25, ns) | ||||
| Kovesdy et al, 201291 | RCT | 80 CKD 3–4 | 50,000 IU weekly to monthly | 16 weeks | 17.2 | 29 | 11.8 | 175 | No change (−9, ns) |
| 1 µg paricalcitol daily | 16.3 | 18 | 1.7 | 168 | Decrease (−49, p<0.001; p=0.009 for between-group comparison) | ||||
| Gravesen et al, 201390 | Randomized | 43 CKD 4–5 | 50,000 IU weekly | 6 weeks | 25.1 | 51.6 | 26.5 | 180 | No change (−12, ns) |
| Control | 23.8 | 24.2 | 0.4 | 168 | No change (+11, ns) | ||||
| Dreyer et al, 201489 | RCT | 22 CKD 3, 16 CKD 4 | 50,000 IU weekly for 4 weeks followed by 50,000 IU monthly for 5 months (450,000 IU) | 24 weeks | ~14* | ~35* | 21 | 103 | No change (−6, ns) |
| Placebo | ~10* | ~10* | 0 | 119 | No change (+17, ns) | ||||
| Thimachai et al, 2015105 | RCT | 68 CKD 3–4 | Double dose of KDOQI regimen | 8 weeks | 21 | 33.4 | 12.4 | 91 | Decrease (−15, p=0.02) |
| KDOQI regimen: 50,000 IU weekly if 25(OH) D <5 ng/mL; 50,000 IU weekly for 4 weeks followed by 50,000 IU monthly if 25(OH)D 5–15 ng/mL; 50,000 IU monthly if 25(OH)D 16–30 ng/mL | 20.8 | 23.4 | 2.6 | 97 | No change (+4, ns) | ||||
| Susantitaphong et al, 201793 | RCT | 68 CKD 3–4 | 40,000 IU weekly + placebo (480,000 IU) | 12 weeks | 15.9 | 30.6 | 14.7 | 85 | No change (+1, ns) |
| 40,000 IU weekly + calcitriol 0.5 µg 2 times per week (480,000 IU) | 19.3 | 33.4 | 14.1 | 89 | Decrease (−15, p=0.04) |
Notes: Only prospective studies with a minimum sample size of 20 patients were included.
Abbreviations: CKD, chronic kidney disease; EOS, end of study; PTH, parathyroid hormone; RCT, randomized controlled trial; ns, not significant; KDOQI, Kidney Disease Outcomes Quality Initiative.