Influence of cholecalciferol supplementation in hemodialysis patients on monocyte subsets: a randomized, double-blind, placebo-controlled clinical trial.

摘要: Background/Aims: Although most hemodialysis patients share a significant 25-hydroxyvitamin D [25(OH)D] deficiency, supplementation is controversially discussed. A potential influence on monocyte and T lymphocyte dysfunction advocates blood level-adapted as recommended by K/DOQI guidelines. This was prospective double-blind randomized placebo controlled trial examining immune effects of 12 weeks cholecalciferol supplementation. Methods: We initiated serum de novo in 38 patients. Outcome measures were: subset cell counts (CD14+CD16++ vs. CD14++CD16+ CD14++CD16-), Th1/Th2 differentiation frequencies, inflammatory proteins CRP TNFα, parathyroid hormone (PTH), FGF-23, α-Klotho. Results: At baseline, the mean 25(OH)D level study population 31.7 ± 14.3 nmol/l, only 3% had levels within normal range. weeks, were normalized verum group (87.8 22.3 24.6 8.0 p 2D increased group. Monocyte well Th1 Th2 frequencies did not change significantly after There also no difference PTH, alkaline phosphatase, calcium, phosphate, α-Klotho levels. Conclusions: Oral according to recommendations normalizes without relevant side such hyperphosphatemia or hypercalcemia. However, beneficial pleiotropic counts, differentiation, cytokine production could be confirmed at least used dosage. PTH FGF23 affected during administration.