A double-blind, randomized, placebo-controlled trial of combined calcitriol and ergocalciferol versus ergocalciferol alone in chronic kidney disease with proteinuria

作者：Susantitaphong Paweena^*; Nakwan Siriwan; Peera****ratana Sadudee; Tiranathanagul Khajohn; Katavetin Pisut; Srisawat Nattachai; Pradit****silpa Kearkiat; Eiam Ong Somchai

来源：BMC Nephrology, 2017, 18(1): 19.

DOI：10.1186/s12882-017-0436-6

• Vitamin D deficiency
• CKD
• Proteinuria
• Ergocalciferol
• Calcitriol

Background: KDOQI guideline suggests that nutritional vitamin D should be supplemented in chronic kidney disease (CKD) patients who have vitamin D insufficiency/deficiency. However, there are scarce data regarding the additional benefit of active vitamin D supplement in CKD patients who were receiving nutritional vitamin D supplement. This study was conducted to explore the effect of adding active vitamin D to nutritional vitamin D supplement on proteinuria and kidney function in CKD with vitamin D insufficiency/deficiency.
Methods: This double-blind, randomized placebo-controlled trial was performed to answer the above question. Sixty-eight patients with CKD stage 3-4, urine protein to creatinine ratio (UPCR) > 1 g/g, and serum 25OH-D level < 30 ng/mL were enrolled. Patients were randomly assigned to receive 12-week treatment with oral ergocalciferol plus placebo (n = 36) or oral ergocalciferol plus calcitriol (n = 32).
Results: The mean baseline values of UPCR of both groups were comparable (3.6 +/- 3.8 g/g in combined group and 3.5 +/- 3.0 g/g in ergocalciferol group). Following 12-week treatment, there were significant reductions in UPCR from baseline in both groups (2.3 +/- 2.1 g/g in combined group and 2.4 +/- 2.0 g/g in ergocalciferol group). The percentage reductions in UPCR of both groups were not significantly different. The mean eGFR and blood pressure did not differ between baseline and 12-week follow-up and between both groups. No severe hypercalcemia or serious side effects were noted in both groups.
Conclusions: The proteinuria lowering effect of ergocalciferol in CKD patients with vitamin D deficiency was demonstrated. Additional calcitriol supplement did not have more effects on proteinuria.

• 出版日期2017-1-14