Clinical observation of active vitamin D supplement in patients with maintenance hemodialysis

Li Xin; Yang Jie; Ding Zhimin

doi:10.3760/cma.j.issn.1673-4777.2017.03.013

Abstract：Objective To observe the clinical effect of active vitamin D supplement on patients with maintenance hemodialysis (MHD).Methods Forty-two patients with 25-hydroxyvitamin D3 [25-(OH) D3] deficiency who had MHD in Beijing Jishuitan Hospital from March to June 2015 were enrolled.The patients had calcitriol 0.25 μg/d at bedtime combined with basic drug treatment and MHD for 12 weeks.Hemoglobin,hematocrit,serum creatinine,albumin,calcium,phosphorus,high sensitivity C-reaction protein (hs-CRP),interleukin-6 (IL-6),25-(OH) D3,intact parathyroid hormone (iPTH),ferritin,serum iron and total iron binding capacity were tested before and after treatment;corrected serum calcium,transferrin saturation(TAST) and urea clearance index(Kt/v) were calculated;the dosage of erythropoietin was recorded.Results One patient was excluded after 4 weeks of treatment due to catheter related infection;1 patient died of acute myocardial infarction after 10 weeks of treatment.Levels of hemoglobin and 25-(OH) D3 in 40 patients after treatment increased significantly compared to those before treatment;levels of hs-CRP and IL-6 decreased significantly compared to those before treatment [(123 ±11)g/L vs (117 ±11)g/L,(18 ±8)μg/L vs (13 ±8)μg/L,(2.9 ±1.8)mg/L vs (4.4 ±4.2)mg/L,(32 ± 9)ng/L vs (48 ± 13) ng/L] (P ＜ 0.05).The dosage of erythropoietin decreased after treatment without significance difference(P ＞ 0.05).Levels of hematocrit,serum creatinine,albumin,corrected serum calcium,phosphorus,iPTH,ferritin,TAST and Kt/V had no significant differences before and after treatment(P ＞ 0.05).Conclusion Supplement of calcitriol can alleviate micro-inflammation,reduce use of erythropoietin and improve anemia during MHD therapy.