Vitamin D May Decrease EPO Requirements by ProQuest


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									10 Renal & Urology News            MAY 2010

  ■ National Kidney Foundation, Orlando, Fla.       Reports from the 2010 National Kidney Foundation’s Spring Clinical Meetings.

 Pre-Dialysis                                   Vitamin D May Decrease
 Preparation                                    EPO Requirements
 May Improve                                    ADMINISTRATION of ergocalciferol          Dr. Larson reported. The absolute
 Survival                                       (vitamin D2) to anemic hemodialysis
                                                (HD) patients receiving erythropoietin
                                                                                          change was an average of 12.2 ng/mL.
                                                                                          The total EPO dose decreased signifi-
 PATIENTS WITH RENAL disease who                (EPO) may decrease EPO require-           cantly by an average of 95,063 units per
 are well prepared to start dialysis
                                                ments, data suggest.                      month. The average hemoglobin (Hb)
                                                  Derek Larson, MD, and colleagues        increased significantly by 0.86 g/dL from
 are significantly more likely to
                                                at Evanston Hospital, NorthShore          baseline to month 9. The researchers
 survive their first year of treatment,
                                                University HealthSystem in Evanston,      also observed no significant association
 a study found.                                 Ill., studied 86 HD patients, of whom     between the change in 25-D levels and
  As part of its Kidney Disease Out-            68 (78%) had 25-hydroxyvitamin D          either Hb or total EPO dose.
 comes Quality Initiative, the National         (25-D) levels below 30 ng/mL at base-       Although the effect of ergocalciferol
 Kidney Foundation has issued guide-            line. These patients received 50,000      treatment on EPO requirement was not       Derek Larson, MD
 lines to help identify renal disease           units of ergocalciferol weekly; pa -      related directly to 25-D levels, further
 sooner in order to improve dialysis            tients with higher 25-D levels received   studies are needed to investigate the      Center found that anemic HD patients
 care. These guidelines recommend               50,000 units monthly. Patients were       impact of 25-D repletion on anemia in      deficient in 25-D who responded to
 that patients should have an arterio-          followed with quarterly labs for          patients with end-stage renal disease,     ergocalciferol supplementation had no
                                                nine months.                              the researchers concluded.                 significant decrease in EPO require-
 venous graft (AVG) or arteriovenous
                                                  During the nine-month follow-up,          In a separate study presented at the     ments and no significant improvement
 fistula (AVF) in place prior to the start
                                                25-D levels increased significantly       conference, investigators at Kaiser        in Hb levels compared with those who
 of dialysis and that they have ad-
                                                from an average of 23 to 36 ng/mL,        Permanente Los Angeles Medical             did not respond. ■
 equate blood hemoglobin levels and
 albumin levels.
  Yelena Slinin, MD, MS, of the Min-
 neapolis VA Medical Center and the
 University of Minnesota in Minne-
                                                Phosphorus, Pulse Pressure Linked
 apolis, and her colleagues studied             HIGHER SERUM phosphorus is                pressure—is a reflection of vascular        After adjusting for age, race, body mass
 192,307 patients who began dialysis            associated with lower pulse pres-         stiffness and therefore may be related     index, smoking, and other potential con-
 between June 1, 2005 and May 31,
                                                sure in women, but not men, with          to vascular calcification associated       founders, women in the highest phospho-
                                                nondialysis-dependent CKD, according      with hyperphosphatemia. Previously,        rus quartile (greater than 4.2 mg/dL) had
 2007 to ascertain whether 
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