Table 4.
Cholecalciferol dosing regimes and associated changes in 25(OH)D and PTH in dialysis (CKD 5D) patients
| Study, year | Type of study | N | Cholecalciferol 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) |
|---|---|---|---|---|---|---|---|---|---|
| Tokmak et al, 2008106 | Prospective cohort | 64 HD | 20,000 IU weekly (720,000 IU) | 36 weeks | 6.7 | 31.8 | 25.1 | 211 | No change (−5, ns) |
| Jean et al, 2009102 | Prospective cohort | 107 HD | 100,000 IU monthly (1,500,000 IU) | 60 weeks | 12.8 | 42.4 | 29.6 | 294 | Decrease (−104, p<0.05) |
| Matias et al, 2010103 | Prospective cohort | 158 HD | 50,000 IU weekly if 25(OH)D <15 ng/mL (1,200,000 IU, 34%) 10,000 IU weekly if 25(OH)D 16–30 ng/mL (240,000 IU, 46%) 2700 IU thrice per week if 25(OH)D >30 ng/mL (194,400 IU, 20%) |
24 weeks | 22.3 | 42 | 19.7 | 233 | Decrease (−25, p<0.001) |
| Armas et al, 2012107 | RCT | 42 HD | 10,333 IU weekly po (154,995 IU) | 15 weeks | 13.3 | 23.6 | 174 | No change (−25.7, ns) | |
| Placebo | 15.2 | 0.5 | 126 | No change (−8.3, ns) | |||||
| Marckmann et al, 201284 | RCT | 27 HD | 40,000 IU weekly (320,000 IU) | 8 weeks | 8.3 | 46 | 170 | No change (−3, ns) | |
| Placebo | 14.4 | −4.2 | 224 | No change (−12, ns) | |||||
| Wasse et al, 2012108 | RCT | 52 HD | 200,000 IU weekly (600,000 IU) | 3 weeks | 14.3 | 52.4 | 38.1 | 722 | No change (−48, ns) |
| Placebo | 19.0 | 18.4 | −0.6 | 624 | No change (−23, ns) | ||||
| Delanaye et al, 2013109 | RCT | 30 HD | 25,000 IU every 2 weeks (600,000 IU) | 48 weeks | 12 | 34 | 22 | 312 | Decrease (−115, p=0.02 between groups) |
| Placebo | 12 | 17 | 5 | 240 | Increase (+80) | ||||
| Hewitt et al, 2013110 | RCT | 60 HD | 50,000 IU weekly for 8 weeks, then monthly for 16 weeks (600,000 IU) | 24 weeks | 18 | 35 | 17 | 335 | No change |
| Placebo | 16 | 16 | 0 | 222 | No change | ||||
| Li et al, 2014111 | RCT | 96 HD | 50,000 IU weekly for 6 weeks, then if 25(OH)D >35ng/mL ↓ 10,000 IU weekly, otherwise continued | 52 weeks | 13.5 | 40.9 | 27.4 | 465 | No change (+91, ns between groups) |
| Placebo | 13.0 | 15.8 | 2.8 | 434 | No change (+203) | ||||
| Massart et al, 2014112 | RCT | 55 HD | 25,000 IU weekly for 13 weeks, afterwards individualized | 39 weeks (13 weeks RCT, 26 weeks open-label) | 17.1 | 35.2 (week 13) | 18.1 | 414 | No change (~ −40, ns between groups) |
| Placebo | 18.4 | 16.4 (week 13) | −2.0 | 427 | No change (~ +50) | ||||
| Mose et al, 2014113 | RCT | 43 HD, 7 PD | 3,000 IU daily (504,000 IU) | 24 weeks | 11.2 | 33.7 | 22.5 | 127 | No change (+37, ns between groups) |
| Placebo | 11.2 | 12 | 0.8 | 170 | No change (−48) | ||||
| Dusilova-Sulkova et al, 2015114 | Prospective cohort | 68 HD | 5,000 IU weekly (75,000 IU) in n=34 | 15 weeks | 7.4 | 27.5 | 20.1 | 205 | Decrease (−34, p=0.05) |
| 10 µg paricalcitol + 5,000 IU weekly (75,000 IU) in n=34 | 7.3 | 27.1 | 19.8 | 364 | Decrease (−44, p=0.01) | ||||
| Zitt et al, 2015101 | Prospective cohort | 44 HD, 12 PD | 100 IU per kg body weight weekly; mean weekly dose 7603 IU (200,000 IU) | 26 weeks | 9.9 | 26.1 | 16.2 | 362 | Decrease (−65, p=0.001) |
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; HD, hemodialysis; PD, peritoneal dialysis; ns, not significant.