Effect of Vitamin D Supplementation on Serum Hepcidin Levels in Non‑Diabetic Chronic Kidney Disease Patients

Document Type

Article

Publication Title

Indian Journal of Nephrology

Abstract

Introduction: Vitamin D deficiency and anemia frequently coexist. Moreover, vitamin D deficiency is found to play a role in chronic kidney disease (CKD)‑associated anemia. We investigated the effect of cholecalciferol on serum hepcidin levels in vitamin D–deficient, non‑diabetic individuals with CKD in a randomized, double‑blind, placebo‑controlled trial. Methods: This study was performed on stored samples of our previously published randomized, double‑blind, placebo‑controlled trial of cholecalciferol supplementation in non‑diabetic patients with stage Ⅲ–Ⅳ CKD and vitamin D deficiency. Stable patients of either sex, aged 18–70 years, with non‑diabetic stage Ⅲ–Ⅳ CKD (estimated glomerular filtration rate between 15 and 60 ml/min/1.73 m2), and having serum 25‑hydroxyvitamin D3 [25(OH) D] levels ≤20 ng/ml were included. Participants received either two directly observed oral doses of cholecalciferol (300,000 IU) or matching placebo at baseline and at eight weeks. Follow‑up was done at 16 weeks. Serum hepcidin levels were analyzed at baseline and at 16 weeks. Results: A total of 120 CKD patients were enrolled. Serum 25(OH) D levels were similar in the placebo and cholecalciferol groups at baseline (13.21 ± 4.78 ng/ml and 13.40 ± 4.42 ng/ml; P = 0.88). After 16 weeks, the serum 25(OH) D levels were found to be increased in the cholecalciferol group but not in the placebo group (between‑group difference in mean change 23.40 ng/ml; 95% CI: 19.76 to 27.06; P < 0.001). Serum hepcidin levels were similar at baseline (median [IQR]: 33.6 [8.6–77.8] ng/ml vs. 24.6 [9.3–70.7] ng/ml, P = 0.903) and did not vary between groups at 16 weeks (median [IQR]: 41.5 [10.9–75.0] ng/ml vs. 34.8 [12.3–63.75] ng/ml, P = 0.703). Conclusion: Our study provides preliminary data based on which a larger adequately powered clinical trial can be conducted to conclusively assess the impact of vitamin D supplementation on hepcidin levels and anemia in patients with CKD and vitamin D deficiency.

First Page

444

Last Page

448

DOI

10.4103/ijn.ijn_28_23

Publication Date

1-1-2023

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