Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D Deficiency: A Randomized Clinical Trial

Miskulin, Dana C.; Majchrzak, Karen M.; Tighiouart, Hocine; Muther, Richard S.; Kapoian, Toros; Johnson, Dianna A.; Weiner, Daniel E.

doi:10.1681/asn.2015040468

Cited by 59 publications

(73 citation statements)

References 49 publications

(75 reference statements)

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“…Musculoskeletal outcomes have not usually been considered in most of existing trials. Although it may be argued that intervention time was too short, in a recent randomized trial providing oral cholecalciferol vs. placebo to haemodialysis patients, no difference in the frequency of falls was noted after 6 months 148. Similarly, only few small studies have addressed the effect of vitamin D on muscle metabolic pathways in renal population 149, 150.…”

Section: Interventional Studies On Vitamin D For Improving Musculoskementioning

confidence: 99%

Vitamin D, a modulator of musculoskeletal health in chronic kidney disease

Molina

Carrero

Bover

et al. 2017

J cachexia sarcopenia muscle

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The spectrum of activity of vitamin D goes beyond calcium and bone homeostasis, and growing evidence suggests that vitamin D contributes to maintain musculoskeletal health in healthy subjects as well as in patients with chronic kidney disease (CKD), who display the combination of bone metabolism disorder, muscle wasting, and weakness. Here, we review how vitamin D represents a pathway in which bone and muscle may interact. In vitro studies have confirmed that the vitamin D receptor is present on muscle, describing the mechanisms whereby vitamin D directly affects skeletal muscle. These include genomic and non‐genomic (rapid) effects, regulating cellular differentiation and proliferation. Observational studies have shown that circulating 25‐hydroxyvitamin D levels correlate with the clinical symptoms and muscle morphological changes observed in CKD patients. Vitamin D deficiency has been linked to low bone formation rate and bone mineral density, with an increased risk of skeletal fractures. The impact of low vitamin D status on skeletal muscle may also affect muscle metabolic pathways, including its sensitivity to insulin. Although some interventional studies have shown that vitamin D may improve physical performance and protect against the development of histological and radiological signs of hyperparathyroidism, evidence is still insufficient to draw definitive conclusions.

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Section: Interventional Studies On Vitamin D For Improving Musculoskementioning

confidence: 99%

Vitamin D, a modulator of musculoskeletal health in chronic kidney disease

Molina

Carrero

Bover

et al. 2017

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

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“…Several possible mechanisms for the association between vitamin D and anemia have been proposed, such as a direct stimulatory proliferative effect of vitamin D on bone marrow cells via VDR (24), silencing of inflammatory reactions that lead to anemia or chronic diseases (25) or parathyroid hormone (PTH)-dependent alteration in erythrocyte osmotic resistance (26). However, so far, the results of observational studies have not been confirmed by RCT (27)(28)(29). In a recent randomized control trial, Ernst et al (27) found no effect of daily vitamin D supplementation (2,800 IU) for 8 wk on hemoglobin level or the reduction of risk of anemia in non-anemic hypertensive patients with various vitamin D statuses.…”

mentioning

confidence: 99%

Iron, Hematological Parameters and Blood Plasma Lipid Profile in Vitamin D Supplemented and Non-Supplemented Young Soccer Players Subjected to High-Intensity Interval Training

Jastrzębska

Kaczmarczyk

Suárez

et al. 2017

J Nutr Sci Vitaminol

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Summary Vitamin D deficiency has been associated with increased risk for cardiovascular disease and anemia. Vitamin D-related changes in lipid profile have been studied extensively but the relationship between vitamin D and lipid metabolism is not completely understood. As both vitamin D and intermittent training may potentially affect iron and lipid metabolism, the aim of the study was to evaluate whether a daily supplementation of vitamin D can modulate the response of hematological and lipid parameters to high-intensity interval training (HIIT) in soccer players. Thirty-six young elite junior soccer players were included in the placebo-controlled, double-blind study. Participants were non-randomly allocated into either a supplemented group (SG, n520, HIIT and 5,000 IU of vitamin D daily) or placebo group (PG, n516, HIIT and sunflower oil). Hematological parameters were ascertained before and after the 8-wk training. The change score (post-and pre-training difference) was calculated for each individual and the mean change score (MCS) was compared between SG and PG using the t test and analysis of covariance. There were no differences between SG and PG at baseline. The red and white cell count, hemoglobin, hematocrit, MCHC, ferritin, and HDL-cholesterol changed significantly over the 8-wk HIIT. However, no significant differences in MCS were observed between SG and PG for any variable. A daily vitamin D supplement did not have any impact on alteration in hematological or lipid parameters in young soccer players in the course of high-intensity interval training. Key Words nutrition, athletic training, sport, interval training, intermittent exercise In recent years, vitamin D has been the subject of intensive research with the primary goal of identifying and understanding its roles beyond the bones, such as cancer, immunity, cardiovascular risk, erythropoiesis, muscle function and athletic performance, to name a few (1, 2). Several lines of evidence, observational studies in particular, suggest that vitamin D lowers the risk of cardiovascular disease (3, 4). Numerous mechanistic explanations for this effect are proposed, such as change in insulin resistance, inflammatory reactions, and parathyroid hormone (PTH), renin and blood pressure levels (5). In addition, owing to a well-known relationship between dyslipidemia and atherosclerotic disease as well as a high prevalence of both vitamin D deficiency and cardiovascular disease, vitamin D-dependent changes in lipid profile have recently been given much attention (6). However, the relationship between vitamin D and lipid metabolism is not completely understood (7-10). Moreover, found that genetically reduced plasma 25-hydroxyvitamin D (25(OH)D) is not associated with increased risk of ischemic heart disease. Moreover, the results of Scragg et al.'s (12) randomized controlled trial (RCT) study showed no evidence that monthly high-dose vitamin D supplementation (100,000 IU a month) prevented cardiovascular diseases.In cross-sectional observational studies, lower p-2...

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“…The paper by Miskulin et al 9 published in this issue of the Journal of the American Society of Nephrology adds to this evolving evidence base and contrasts with an earlier crosssectional study 10 that reported a 2.8-fold increase in anemia prevalence for patients with CKD who were in the lowest versus the highest tertile of serum 25OHD values. This study by Miskulin et al 9 randomized 276 patients on hemodialysis with baseline 25OHD levels #12 ng/ml (30 nmol/L) to ergocalciferol or placebo for 6 months.…”

mentioning

confidence: 83%

“…The study reports no significant differences between groups in the primary end point of epoetin requirements or in BP, change in serum PTH, phosphorus, calcium, inflammatory markers, or use of cinacalcet, calcitriol, or phosphate binders. 9 These data 9 and those of a similar but smaller randomized, controlled trial using cholecalciferol 11 erode support for the use of nutritional vitamin D in the short-term management of anemia for patients on dialysis or patient-level outcomes assessed by functional or muscle strength testing, BP control, differences in lipids, insulin resistance, inflammatory markers, vascular compliance as measured by pulse wave velocity, or quality of life. Although vitamin D is relatively inexpensive and adverse effects are infrequent, the additional pill burden and lack of proven efficacy suggest that, for patients with vitamin D values in the described range, relatively short-term treatment for those indications is unjustified.…”

mentioning

confidence: 99%

“…This study by Miskulin et al 9 randomized 276 patients on hemodialysis with baseline 25OHD levels #12 ng/ml (30 nmol/L) to ergocalciferol or placebo for 6 months. Treatment was effective, with 25OHD values rising from 16.065.9 to 39.2614.9 ng/ml (40615 to 98637 nmol/L) in the ergocalciferol arm, and there was no significant change for patients receiving placebo.…”

mentioning

confidence: 99%

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