One‑year cholecalciferol supplementation fails to improve bone mineral density or inflammation in patients with vitamin D deficiency undergoing hemodialysis

Deficiency in 25‑hydroxyvitamin D [25(OH)D] is prevalent among patients undergoing hemodialysis (HD) and is associated with poorer clinical outcomes. The KDIGO guidelines advocate for 25(OH)D supplementation in these patients. In the present study, cholecalciferol was administered to patients undergoing HD exhibiting 25(OH)D deficiency over a period of 1 year. After excluding non‑compliant participants, 20 patients completed the study. Bone mineral density (BMD), as well as the T‑score and Z‑score of the lumbar spine and total hip were assessed pre‑ and post‑supplementation using dual‑energy X‑ray absorptiometry. Additionally, the serum levels of 25(OH)D, intact parathyroid hormone (iPTH), calcium, phosphorus, C‑reactive protein (CRP) and the neutrophil‑to‑lymphocyte ratio were evaluated. Cholecalciferol supplementation increased the 25(OH)D levels; however, it did not result in significant changes in lumbar spine T‑score, Z‑score or BMD. However, a decrease in the total hip T‑score and BMD was observed by the end of the study period. The serum levels of iPTH, calcium and phosphorus remained stable. Similarly, the levels of inflammation markers, including CRP and the neutrophil‑to‑lymphocyte ratio, did not exhibit any significant changes. Thus, the present study demonstrates that 1‑year cholecalciferol supplementation increases the 25(OH)D levels, but does not improve BMD or inflammation among patients with vitamin D deficiency undergoing HD. Further investigations with larger patient cohorts are required to confirm these findings and to potentially reconsider the relevant KDIGO guidelines.