{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:52:28Z","timestamp":1787017948891,"version":"build-2736575974"},"reference-count":21,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Nephrol"],"abstract":"Introduction: Vitamin D insufficiency is common in patients who receive hemodialysis, yet there is no clear guidance regarding surveillance or treatment. We hypothesized that increasing 25(OH)D<sub>3<\/sub> levels is associated with lower phosphate, parathyroid hormone (PTH), and alkaline phosphatase (ALP). Methods: Baseline 25(OH)D<sub>3<\/sub> level was measured in all patients receiving in-center hemodialysis in June 2017. Laboratory parameters were measured every 6 (phosphate, calcium) or 12 weeks (25(OH)D<sub>3<\/sub>, PTH, ALP) until February 2021. In September 2018, a treatment algorithm of 50,000 IU weekly until sufficient followed by 50,000 IU monthly was suggested. Generalized linear mixed regression models including linear spline effects, a log link function, and random effects were used to examine the impact of increasing 25(OH)D<sub>3<\/sub> levels on calcium, phosphate, ALP, and PTH. Results: Of 697 participants, 15% and 57% had vitamin D deficiency (25(OH)D<sub>3<\/sub> &lt;25 nmol\/L) and insufficiency (between 25 and 74 nmol\/L). Incorporating up to 7,272 observations, increasing 25(OH)D<sub>3<\/sub> was associated with significantly decreasing PTH for 25(OH)D<sub>3<\/sub> levels between 25 and 75 nmol\/L regardless of vitamin D treatment. In an interaction model, the negative slope between 25(OH)D<sub>3<\/sub> and PTH remained significant beyond 75 nmol\/L in the absence of calcitriol. Increasing 25(OH)D<sub>3<\/sub> was associated with significantly decreasing phosphate for 25(OH)D<sub>3<\/sub> levels between 25 and 75 nmol\/L regardless of vitamin D treatment and below 25 nmol\/L in values of untreated patients. Calcium increased across the spectrum of 25(OH)D<sub>3<\/sub> regardless of vitamin D treatment. Overall, 0.2% of 25(OH)D<sub>3<\/sub> levels exceeded 250 nmol\/L and 2.1% of calcium levels exceeded the normal range. Conclusions: Vitamin D treatment in a real-world setting was safe and associated with lower PTH levels. Whether improved biochemical markers translate to a reduction in clinical endpoints warrants further study.<\/jats:p>","DOI":"10.1159\/000541109","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T17:03:55Z","timestamp":1725296635000},"page":"1-9","source":"Crossref","is-referenced-by-count":2,"title":["Vitamin D Status and Treatment in ESKD: Links to Improved CKD-MBD Laboratory Parameters in a Real-World Setting"],"prefix":"10.1159","author":[{"given":"Rachel M.","family":"Holden","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick A.","family":"Norman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G.","family":"Day","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel A.","family":"Silver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen K.","family":"Clemens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Iliescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2017.04.001"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002451"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq606"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2020.1735415"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy016"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.188"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.31"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0385"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.05.018"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1159\/000499187"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/nu13103603"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3390\/nu14071448"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-022-00732-z"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1177\/2054358120944271"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2019.1632719"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06910714"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2018.10.008"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqab390"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-16-s2-o15"}],"container-title":["American Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/ajn\/article-pdf\/doi\/10.1159\/000541109\/4285177\/000541109.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/ajn\/article-pdf\/doi\/10.1159\/000541109\/4285177\/000541109.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T11:37:54Z","timestamp":1745408274000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000541109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,2]]},"references-count":21,"URL":"https:\/\/doi.org\/10.1159\/000541109","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.26879290","asserted-by":"subject"}]},"ISSN":["0250-8095","1421-9670"],"issn-type":[{"value":"0250-8095","type":"print"},{"value":"1421-9670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,2]]}}}