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Authors Cupisti A, Vigo V, Baronti ME, D’Alessandro C, Ghiadoni L, Egidi MF


Received 23 June 2015


Accepted for publication 11 August 2015


Published 19 November 2015 Volume 2015:8 Pages 151—157



DOI http://dx.doi.org/10.2147/IJNRD.S90968


Checked for plagiarism Yes


Review by Single-blind


Peer reviewers approved by Dr Xu-jie Zhou


Peer reviewer comments 5


Editor who approved publication:
Professor Pravin Singhal



Adamasco Cupisti, Valentina Vigo, Maria Enrica Baronti, Claudia D’Alessandro, Lorenzo Ghiadoni, Maria Francesca Egidi

Nephrology, Transplant and Dialysis Division, AOUP, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

Abstract: This study investigated the factors associated with hypovitaminosis D, in a cohort of 405 prevalent patients with chronic kidney disease (CKD) stages 2–4, living in Italy and followed-up in tertiary care. The effect of cholecalciferol 10,000 IU once-a-week for 12 months was evaluated in a subgroup of 100 consecutive patients with hypovitaminosis D. Vitamin D deficiency was observed in 269 patients (66.4%) whereas vitamin D insufficiency was found in 67 patients (16.5%). In diabetic patients, 25-hydroxyvitamin D deficiency was detected in 80% of cases. In patients older than 65 years, the prevalence of hypovitaminosis D was 89%. In the univariate analysis, 25-hydroxyvitamin D was negatively related to age, parathyroid hormone (PTH), proteinuria, and Charlson index, while a positive relationship has emerged with hemoglobin level. On multiple regression analysis, only age and PTH levels were independently associated with 25-hydroxyvitamin D levels. No relationship emerged between vitamin D deficiency and renal function. Serum levels of 25-hydroxyvitamin D or prevalence of hypovitaminosis D did not differ between patients on a free-choice diet and on a renal diet, including low-protein, low-phosphorus regimens. Twelve-month oral cholecalciferol administration increased 25-hydroxyvitamin D and reduced PTH serum levels. In summary, hypovitaminosis D is very prevalent in CKD patients (83%) in Italy, and it is similar to other locations. PTH serum levels and age, but not renal function, are the major correlates of hypovitaminosis D. Implementation of renal diets is not associated with higher risk of vitamin D depletion. Oral cholecalciferol administration increased 25-hydroxyvitamin D and mildly reduced PTH serum levels. Oral cholecalciferol supplementation should be recommended as a regular practice in CKD patients, also when serum 25-hydroxyvitamin D determination is not available or feasible.

Keywords: CKD, vitamin D, cholecalciferol, calcifediol, hypovitaminosis, PTH, renal disease, CKD-MBD


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