MP580COMPARISON OF BOLUS DOSE VS. DAILY ADMINISTRATION OF CHOLECALCIFEROL, IN VITAMIN D SUPPLEMENTATION FOR HEMODIALYSIS PATIENTS

Abstract

Introduction and Aims: Whether bolus and daily cholecalciferol supplementation are equally safe and effective to increase serum 25‐hydroxyvitamin D [25(OH)D] levels in chronic hemodialysis patients remains controversial. The aims of this study were to assess the safety profile of bolus cholecalciferol supplementation and compare its effectiveness to daily oral administration in patients on hemodialysis. Methods: This 6‐month prospective, intervention study enrolled 60 stable hemodialysis patients (mean age: 66+/‐15 years; 40% female, 28% diabetics) with 25(OH)D levels <30 ng ml, who received cholecalciferol 25,000 IU once or twice monthly (n = 30) or 700 IU daily (n = 30). Differences in biochemical parameters, including 25(OH)D, calcium, phosphorous, parathyroid hormone (PTH), alkaline phosphatase and high‐sensitive C‐reactive protein levels, were analyzed monthly. Primary outcome was 25OH(D) level at 6 months. For safety purposes, in the subgroup of patients receiving the bolus regimen, calcium, phosphorus and 25OH(D) levels were also assessed on days 2, 4 and 7 after the first bolus dose. Results: At baseline, patient and biochemical characteristics were similar in both groups. No changes were observed in calcium, phosphorus and 25OH(D) levels in the first week after the first bolus dose. Throughout the 6‐month follow‐up, similar responses in 25OH(D) levels and other biochemical parameters were observed in both groups (Table). Conclusions: Supplementation of 25,000 IU fortnightly or monthly oral cholecalciferol seems to be safe, being equally effective for raising 25(OHD) levels than 700 IU daily cholecalciferol administration. Bolus cholecalciferol supplementation administered during dialysis session, is an attractive dosage form to ensure 100% adhesion in hemodialysis patients. Nevertheless, these results should be confirmed in randomized clinical trials. (Table Presented).