• Ziyad Al-Aly, Rizwan A Qazi, Esther A González, Angelique Zeringue, and Kevin J Martin.
• Division of Nephrology, Saint Louis Veterans Affairs Medical Center, St Louis, MO 63106, USA. ziyad.alaly@va.gov <ziyad.alaly@va.gov>
• Am. J. Kidney Dis. 2007 Jul 1;50(1):59-68.

BackgroundVitamin D insufficiency and deficiency are very common in patients with chronic kidney disease (CKD). The effect of ergocalciferol administration on serum 25-hydroxyvitamin D and plasma intact parathyroid hormone (PTH) levels in these patients is not known.Study DesignRetrospective study.Setting & ParticipantsPatients with CKD stage 3 or 4 who had a serum 25-hydroxyvitamin D level less than 30 ng/mL (<75 nmol/L) and increased plasma intact PTH level were treated with 50,000 IU of ergocalciferol once weekly for 12 weeks and once monthly thereafter for a total of 6 months. Patients were excluded if they had a history of active vitamin D sterol use.Outcome & Measurements25-Hydroxyvitamin D and intact PTH were measured at baseline and follow-up.Results66 patients met inclusion criteria. Average age was 70.4 +/- 1.3 (SE) years (range, 40 to 88 years), and 97% were men. There were 44 patients (66%) with CKD stage 3 and 22 patients (33%) with CKD stage 4. After a median follow-up of 6 months, there was a significant increase in 25-hydroxyvitamin D levels from 16.6 +/- 0.7 to 27.2 +/- 1.8 ng/mL (41 +/- 2 to 68 +/- 4 nmol/L; P < 0.05) and a significant decrease in plasma intact PTH levels from 231 +/- 26 to 192 +/- 25 pg/mL (ng/L; P < 0.05). A multivariate logistic regression model showed that an increase in 25-hydroxyvitamin D level greater than 5 ng/mL (>12 nmol/L) is associated with a significant likelihood of a greater than 30% decrease in plasma intact PTH level (odds ratio, 4.5; 95% confidence interval, 1.5 to 15.1; P < 0.05). Although posttreatment 25-hydroxyvitamin D levels were not different between patients with CKD stages 3 and 4, only patients with CKD stage 3 had a significant decrease in plasma intact PTH levels.LimitationsThis is a retrospective study with mostly male patients.ConclusionsResults show that ergocalciferol administration has a favorable effect on PTH levels if therapy results in an increase in 25-hydroxyvitamin D levels; this effect is more evident in patients with CKD stage 3.

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