Table 1.
References | Study length | Risk of bias | Study arms | Dose | Number of patients | Age (years) | Percentage of female | Baseline eGFR (mL/min/ 1.73 m2) | Baseline PTH (pg/mL) | Baseline 25(OH)D (ng/mL) |
---|---|---|---|---|---|---|---|---|---|---|
Panel A: Studies comparing NVD versus placebo or no treatment (used in analyses of change versus placebo/no treatment and in analyses of changes in NVD study arms) | ||||||||||
Alvarez et al. [24] | 52 weeks | Moderate | Cholecalciferol | 50 000 IU/week first 12 weeks, 50 000 IU/ every other week rest of study (approximate average weekly dose of 30 800 IU) | 22 | 63.2 | 9.1 | 62.5 | 89.1 | 26.7 |
Placebo | NA | 24 | 62.6 | 8.3 | 61.2 | 78.2 | 32.1 | |||
Chandra et al. [25] | 12 weeks | High | Cholecalciferol | 50 000 IU/week | 17 | 62.2 | 60 | 33.3 | 288.9a | 17.3a |
Placebo | NA | 17 | 59.5 | 60 | 29.8 | 290.5a | 18.6a | |||
Dogan et al. [30] | 4 weeks | High | Cholecalciferol | 300 000 IU/month (only one treatment) (approximate average weekly dose of 75 000 IU) | 20 | 51 | 18 | 36.3 | 368 | 8.5f |
No treatment | NA | 20 | 47 | 18 | 34.6 | 273 | 6.8f | |||
Dreyer et al. [26] | 26 weeks | High | Ergocalciferol | 50 000 IU/week first month, 50 000 IU/month remaining 5 months (approximate average weekly dose of 18 300 IU) | 20 | 45.8 | 39.1 | 33 | 102.8 | NA |
Placebo | NA | 18 | 48.8 | 26.3 | 38.7 | 118.9 | NA | |||
Gravesen et al. [29] | 6 weeks | High | Ergocalciferol | 50 000 IU/week | 26 | NA | NA | 20.1 | 180.1 | 25 |
No treatment | NA | 17 | NA | NA | 20.9 | 166.252 | 23.72 | |||
Kumar et al. [27] | 16 weeks | Moderate | Cholecalciferol | 300 000 IU/month (only two treatments) (approximate average weekly dose of 75 000 IU) | 60 | 43.2 | 29 | 35.8 | 139b | 13.4 |
Placebo | NA | 60 | 45.2 | 32 | 34.6 | 146b | 13.2 | |||
Marckmann et al. [28]d | 8 weeks | Moderate | Cholecalciferol | 40 000 IU/week | 13 | 71b,c | 27b,c | 32b,c | 79.2b | 15.7b |
Placebo | NA | 12 | 68b,c | 23b,c | 29b,c | 119.8b | 11.4b | |||
Petchey et al. [21] | 26 weeks | Moderate | Cholecalciferol | 2000 IU/day (approximate average weekly dose of 14 000 IU) | 13 | 65 | 46 | 39 | 84.9b | 38 |
Placebo | NA | 15 | 67 | 13 | 41 | 103.7b | 35.2 | |||
Westerberg et al. [18] | 12 weeks | Low | Cholecalciferol | 8000 IU/day (approximate average weekly dose of 56 000 IU) | 48 | 62.6 | 44 | 32 | 102.8 | 23 |
Placebo | NA | 49 | 64 | 20 | 29.5 | 123.5 | 22.7 | |||
Summary Panel A: | Approximate average weekly dose 45 448 IU | 471 (sum) | 52.5 (average) | 32.9 (average) | 35.7 (average) | 158.7 (average) | 20.7 (average) | |||
| ||||||||||
Panel B: Studies investigating an NVD compared with another NVD or a non-relevant comparator (used only in analysis of changes in NVD study arms) | ||||||||||
Kendrick et al. [20] | 26 weeks | Very low | Cholecalciferol | 4000 IU/day first month, 2000 IU/day remaining 5 months (approximate average weekly dose of 16 200 IU) | 64 | 58 | 30 | 33.5 | 99.5c | 23 |
Calcitriole | 0.25 μg/day first month, 0.5 μg/day months 2–6 (if no episode of hypercalcaemia) | 64 | 59 | 36 | 32.8 | 93.8c | 21.7 | |||
Kovesdy et al. (2012) [34] | 16 weeks | Moderate | Ergocalciferol | Dosed according to baseline 25(OH)D levels (as recommended by KDOQI) (average weekly dose not available) | 40 | 67.6 | 0 | 30.9 | 175 | 17.2 |
Paricalcitole | 1 μg/day | 40 | 69.3 | 2 | 32.1 | 168 | 16.3 | |||
Moe et al. [33] | 13 weeks | High | Cholecalciferol | 4000 IU/day first month, 2000 IU/day remaining months (approximate average weekly dose of 18 300 IU) | 22 | 62 | 54 | 29.6 | 109 | 14 |
Doxercalciferole | 0.5 μg/day | 25 | 65 | 36 | 36.4 | 106 | 15.1 | |||
Wetmore et al. [31] | 12 weeks | Moderate | Ergocalciferol | 50 000 IU/week | 22 | 59.4 | 47.6 | 37.5 | 149 | 20.5 |
Cholecalciferol | 50 000 IU/week | 22 | 56.7 | 65 | 42.5 | 76.6 | 20.9 | |||
Zhang et al. [32] | Mean follow-up 144 weeks | Moderate | Ergocalciferol | 50 000 IU/week first 3 months, maintained at 50 000 IU/month according to 25(OH)D levels (approximate average weekly dose of 50 000 IU) | 104 | 57.4 | 28.8 | 41.6 | 109.7 | 15.14 |
Calcitriole | 0.25 μg/day (dose adjusted in response to changes in 25(OH)D, Ca, P and PTH) | 100 | 56.3 | 34 | 42.9 | 89.5 | 14.9 | |||
Summary Panel B: | Approximate average weekly dose 33 615 IU | 503 (sum) |
61.1 (average) |
32.4 (average) |
36.0 (average) |
117.6 (average) |
17.9 (average) |
|||
Summary all studies: | Approximate average weekly dose 41 807 IU | 974 (sum) |
55.8 (average) |
32.7 (average) | 35.8 (average) | 144.0 (average) | 19.6 (average) |
Numbers refer to geometric mean value.
Numbers refer to median values.
Numbers include measures for the full population of both dialysis and ND patients included in the study.
In the publication by Marckmann et al., only median value changes are reported, however, mean value changes for both PTH and 25(OH)D were obtained from the authors via e-mail, and as such, the results presented in the Results sections below refer to mean values and not median values.
The values from these comparator arms will not be used in any of the analyses performed in this meta-analysis.
In the publication by Dogan et al., values are reported as pg/mL of calcidiol. No change in the estimated values or conversion of units has been made for these values in any of the analyses performed on 25(OH)D.
NA, not applicable; KDOQI, Kidney Disease Outcomes Quality Initiative; Ca, calcium; P, phosphorus.