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Open Access Highly Accessed Research article

Cardiovascular effects of cholecalciferol treatment in dialysis patients – a randomized controlled trial

Frank H Mose12*, Henrik Vase4, Thomas Larsen1, Anne SP Kancir1, Renata Kosierkiewic2, Bartlomiej Jonczy2, Annebirthe B Hansen3, Anna E Oczachowska-Kulik2, Ingrid M Thomsen2, Jesper N Bech12 and Erling B Pedersen12

Author Affiliations

1 University Clinic in Nephrology and Hypertension, Department of Medical Research and University of Aarhus, Holstebro Hospital, Holstebro, Denmark

2 Department of Medicine, Holstebro Hospital, Laegaardvej 12, Holstebro 7500, Denmark

3 Department of Clinical Biochemistry, Holstebro Hospital, Holstebro, Denmark

4 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

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BMC Nephrology 2014, 15:50  doi:10.1186/1471-2369-15-50

Published: 24 March 2014

Abstract

Background

Patients on chronic dialysis are at increased risk of vitamin D deficiency. In observational studies plasma 25-hydroxyvitamin D (p-25(OH) D) levels are inversely correlated with plasma BNP and adverse cardiovascular outcomes. Whether a causal relation exists has yet to be established. The aim of this study was to test the hypothesis that cholecalciferol supplementation improves cardiac function and reduces blood pressure (BP) and pulse wave velocity (PWV) in patients on chronic dialysis.

Methods

In a randomized, placebo-controlled, double-blind study, we investigated the effect of 75 μg (3000 IU) cholecalciferol daily for 6 months, in patients on chronic dialysis. We performed two-dimensional echocardiography, with doppler and tissue-doppler imaging, 24-h ambulatory BP (24-h BP), PWV, augmentation index (AIx), central BP (cBP) and brain natriuretic peptide (BNP) measurements at baseline and after 6 months.

Results

Sixty-four patients were allocated to the study. Fifty dialysis patients with a mean age of 68 years (range: 46–88) and baseline p-25(OH) D of 28 (20;53) nmol/l completed the trial. Cholecalciferol increased left ventricular (LV) volume, but had no impact on other parameters regarding LV structure or left atrial structure. LV systolic function, LV diastolic function, PWV, cBP, AIx and BNP were not changed in placebo or cholecalciferol group at follow-up. 24-h BP decreased significantly in placebo group and tended to decrease in cholecalciferol group without any difference between treatments.

Conclusion

Six months of cholecalciferol treatment in patients on chronic dialysis did not improve 24-h BP, arterial stiffness or cardiac function.

Trial registration

NCT01312714, Registration Date: March 9, 2011.

Keywords:
Cholecalciferol; Chronic kidney disease; Cardiac function; Brain natriuretic peptide; Blood pressure