Effect of cholecalciferol replacement on vascular calcification and left ventricular mass index in dialysis patients

Figures & data

Table 1. Baseline characteristics of study groups.

	Cholecalciferol group (n = 26)	Standard treatment group (n = 17)	p Value
Age (year)	53.8 ± 17.3	57.8 ± 10.4	0.391
Male, n (%)	11 (42)	9 (53)	0.499
Hemodialysis, n (%)	13 (50)	8 (47)	0.850
Dialysis duration (month)	47.6 ± 60.4	58.8 ± 50.5	0.529
Diabetes mellitus, n (%)	5 (19)	5 (29)	0.440
Smoking, n (%)	5 (19)	4 (24)	0.735
Body surface area (m^2)	1.67 ± 0.24	1.68 ± 0.19	0.822
Drugs, n (%)
ACEI/ARB	5 (19)	5 (29)	0.440
Calcium channel blockers	3 (12)	5 (29)	0.141
Beta blockers	5 (19)	4 (24)	0.735
Loop diuretics	6 (23)	4 (24)	0.973
Calcitriol	14 (54)	6 (35)	0.233
Cinecalcet	3 (12)	1 (6)	0.532
CA/CC	16 (62)	11 (65)	0.834
Sevelamer	2 (8)	0 (0)	0.242
Erythropoetin analogue	15 (58)	9 (53)	0.759
Statins	2 (8)	3 (18)	0.319
Laboratory values
25(OH)D (ng/mL)	7.3 ± 5.5	9.1 ± 13.9	0.558
Kt/V	1.9 ± 1.0	2.1 ± 0.9	0.690
Ca (mg/dL)	8.3 ± 1.2	8.8 ± 0.8	0.095
P (mg/dL)	4.8 ± 1.1	5.2 ± 1.2	0.301
Albumin (g/dL)	3.5 ± 0.5	3.6 ± 0.4	0.678
Uric acid (mg/dL)	5.9 ± 1.2	6.1 ± 2.0	0.727
iPTH (pg/mL)	464 ± 364	552 ± 557	0.536
Hemoglobin (g/dL)	11.2 ± 1.3	11.2 ± 1.6	0.925
C-reactive protein (mg/dL)	7.3 ± 4.6	9.2 ± 5.3	0.216

Notes: ACEI: angiotensin converting enzyme inhibitor, ARB: angiotensin receptor blocker, CA: calcium acetate, CC: calcium carbonate, Ca: calcium, P: phosphate, iPTH: intact parathyroid hormone. These values were compared between groups with Student's t-test or chi-square test. Values are expressed as mean ± SD, if not specified.

Table 2. Baseline and sixth month evaluations of cholecalciferol treatment group (n = 26).

	Baseline	6 months	p Value
25(OH)D (ng/mL)	7.3 ± 5.5	38.0 ± 13.2	0.001
Ca (mg/dL)	8.3 ± 1.2	8.5 ± 1.2	0.118
P (mg/dL)	4.8 ± 1.1	4.9 ± 1.4	0.643
iPTH (pg/mL)	464 ± 364	447.8 ± 451.7	0.686
Albumin (g/dL)	3.5 ± 0.5	3.7 ± 0.5	0.031
Hemoglobin (g/dL)	11.2 ± 1.3	10.7 ± 1.5	0.051
C-reactive protein (mg/dL)	7.3 ± 4.6	5.5 ± 2.8	0.014
Left atrium diameter (mm)	41.2 ± 8.9	38.9 ± 8.1	0.006
Left atrial volume index (mL/m^2)	30.5 ± 8.6	29.5 ± 8.7	0.515
Left ventricular end-diastolic  diameter (mm)	48.8 ± 5.1	47.5 ± 4.6	0.023
Mitral E velocity (cm/s)	8.1 ± 2.2	7.9 ± 2.2	0.767
Mitral A velocity (cm/s)	10.0 ± 1.2	9.1 ± 1.7	0.002
E/A	0.8 ± 0.3	0.9 ± 0.3	0.170
Mitral annular early velocity  (E′) (cm/s)	9.5 ± 3.3	9.9 ± 3.2	0.519
E/E′	0.9 ± 0.3	0.8 ± 0.3	0.471
LVEF (%)	63.7 ± 5.9	63.8 ± 5.0	0.943
Left ventricular mass index (g/m^2)	138 ± 37.9	141.8 ± 40.2	0.611
Vascular calcification score	1.6 ± 2.1	1.8 ± 2.1	0.096

Notes: Ca: calcium, P: phosphate, iPTH: intact parathyroid hormone. Values are given as mean ± SD. p-Value for a paired t-test for within treatment groups variation over 6 months.

Figure 1. Comparison of left ventricular mass index (LVMI) values of study groups. These values were compared between standard treatment and cholecalciferol groups with Student's t-test. Note: Values (g/m²) are expressed as mean ± SD.

Table 3. Comparison of baseline and sixth month evaluations of study groups.

	Baseline	6th month	p Value
25(OH)D (ng/mL)
Standard treatment	9.1 ± 13.9	12 ± 6.6	<0.001
Cholecalciferol	7.3 ± 5.5	38.0 ± 13.2
Ca (mg/dL)
Standard treatment	8.9 ± 0.8	8.6 ± 0.9	0.01
Cholecalciferol	8.3 ± 1.2	8.5 ± 1.2
P (mg/dL)
Standard treatment	5.0 ± 0.2	5.7 ± 1.9	0.31
Cholecalciferol	4.8 ± 1.1	4.9 ± 1.4
iPTH (pg/mL)
Standard treatment	588 ± 612	617 ± 844	0.60
Cholecalciferol	464 ± 364	447.8 ± 451
Albumin (g/dL)
Standard treatment	3.6 ± 0.5	3.5 ± 0.3	0.15
Cholecalciferol	3.5 ± 0.5	3.7 ± 0.5
Hemoglobin (g/dL)
Standard treatment	10.9 ± 1.4	10.7 ± 1.6	0.64
Cholecalciferol	11.2 ± 1.3	10.7 ± 1.5
C-reactive protein (mg/dL)
Standard treatment	9.4 ± 5.3	8.9 ± 4.9	0.13
Cholecalciferol	7.3 ± 4.6	5.5 ± 2.8
Left ventricular mass  pindex (g/m^2)
Standard treatment	146.5 ± 41.4	166.3 ± 31.4	0.23
Cholecalciferol	138 ± 37.9	141.8 ± 40.2
Left atrium diameter (mm)
Standard treatment	40.2 ± 3.3	40.0 ± 1.8	0.05
Cholecalciferol	41.2 ± 8.9	38.9 ± 8.1
Left ventricular end-diastolic  diameter (mm)
Standard treatment	48.9 ± 5.9	49.4 ± 4.6	0.06
Cholecalciferol	48.8 ± 5.1	47.5 ± 4.6
E/A
Standard treatment	0.8 ± 0.3	0.9 ± 0.2	0.62
Cholecalciferol	0.8 ± 0.3	0.9 ± 0.3
E/E′
Standard treatment	0.9 ± 0.3	1.1 ± 0.3	0.007
Cholecalciferol	0.9 ± 0.3	0.8 ± 0.3
Left ventricular ejection fraction  (biplane) (%)
Standard treatment	63.8 ± 7.3	64.6 ± 5.7	0.71
Cholecalciferol	63.7 ± 5.9	63.8 ± 5.0
Vascular calcification score
Standard treatment	1.9 ± 2.8	2.2 ± 3.1	0.87
Cholecalciferol	1.6 ± 2.1	1.8 ± 2.1

Notes: Ca: calcium, P: phosphate, iPTH: intact parathyroid hormone. Values are given as mean ± SD. p-Values represent the probability of a difference in response to treatment between group. Statistics are performed with Student's t-test. Statistical significant difference from baseline compared with paired t-test.