The Effect of Vitamin D Deficiency Treatment on Hemoglobin Levels in Hemodialysis Patients: A Double-blind, Randomized Controlled Trial

F. Ghasemian, Shahla Ahmadi Halili, F. Hayati, S. S. Beladi-Mousavi, Shokouh Shayanpour, Leila Sabetnia
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Abstract

Background: The role of vitamin D deficiency and inflammation levels in renal anemia is well established. However, few studies with inconsistent findings have examined the relationship between vitamin D supplementation and the prevalence and severity of anemia in the chronic kidney disease. Objectives: The present study aimed to evaluate the effect of vitamin D deficiency treatment on hemoglobin levels in hemodialysis patients. Methods: The present study was a double-blind, randomized controlled trial on 60 hemodialysis patients aged 18 - 83 years, who were undergoing weekly dialysis and receiving erythropoietin. These patients with vitamin D (< 30 ng/mL) referred to the dialysis wards of Imam Khomeini, Razi, and Sina hospitals in Ahvaz in 2019 and were assigned into two groups. One group was treated with 500 mg oral calcium-D tablets three times a day, and another group was treated with 50,000 units of D-Pearls weekly. The two groups were treated for 12 weeks. Then they were re-evaluated in terms of response to treatment and the rate of improvement in hemoglobin levels and erythropoietin dose. Results: In each intervention group, vitamin D levels increased significantly (P < 0.001). D-Pearls improved vitamin D deficiency; however, the difference was not statistically significant. This study also showed a significant increase in hemoglobin (> 1 unit) in the Calcium-D group; however, such a change was not observed in the D-Pearls group (P = 0.3824). Moreover, there was no difference between the two groups in terms of erythropoietin consumption (P = 0.98), blood calcium level (P = 0.57), parathyroid level (P = 0.20), and phosphorus (P = 0.99). Conclusions: Despite its significant limitations, this study revealed vitamin D supplements compensated for vitamin D deficiency, and Calcium-D tablets could improve hemoglobin levels in patients.
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维生素D缺乏治疗对血透患者血红蛋白水平的影响:一项双盲、随机对照试验
背景:维生素D缺乏和炎症水平在肾性贫血中的作用已得到证实。然而,很少有研究结果不一致,研究了维生素D补充与慢性肾病中贫血的患病率和严重程度之间的关系。目的:探讨维生素D缺乏治疗对血液透析患者血红蛋白水平的影响。方法:本研究是一项双盲、随机对照试验,研究对象为60例血液透析患者,年龄18 ~ 83岁,每周透析并接受促红细胞生成素治疗。这些维生素D (< 30 ng/mL)的患者于2019年转至阿瓦士伊玛目霍梅尼、拉齐和新浪医院的透析病房,并被分为两组。一组服用500毫克口服d钙片,每天三次,另一组每周服用5万单位D-Pearls。两组均治疗12周。然后重新评估他们对治疗的反应以及血红蛋白水平和促红细胞生成素剂量的改善率。结果:各干预组维生素D水平均显著升高(P < 0.001)。D-珍珠改善维生素D缺乏症;然而,差异无统计学意义。本研究还显示,钙d组血红蛋白显著升高(>.1单位);然而,D-Pearls组没有观察到这种变化(P = 0.3824)。此外,两组在促红细胞生成素消耗(P = 0.98)、血钙水平(P = 0.57)、甲状旁腺水平(P = 0.20)和磷水平(P = 0.99)方面均无差异。结论:尽管存在明显的局限性,但该研究表明,维生素D补充剂可以弥补维生素D缺乏症,钙D片可以改善患者的血红蛋白水平。
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