Failure of High-dose Ergocalciferol to Correct Vitamin D Deficiency in Adults with Cystic Fibrosis

Overview

Journal Am J Respir Crit Care Med

Specialty Critical Care

Date 2005 Apr 30

PMID 15860755

Citations 17

Authors

Michael P Boyle

Michelle L Noschese

Sharon L Watts

Marsha E Davis

Shane E Stenner

Noah Lechtzin

Affiliations

Soon will be listed here.

Abstract

Rationale: Treatment guidelines for vitamin D monitoring and supplementation in cystic fibrosis (CF) have recently been developed and published by a consensus committee, but have not been prospectively tested.

Objectives: To use these guidelines to determine the percentage of adults with CF requiring vitamin D repletion therapy and to evaluate the effectiveness of the currently recommended high-dose oral ergocalciferol repletion protocol.

Methods: Prospective study of clinical outcomes after therapy with the recommended vitamin D repletion algorithm.

Results: Of 134 adults with CF, 109 (81.3%) were found to have 25-hydroxyvitamin D (25-OHD) levels below the recommended 30 ng/ml. Sixty-six of these adults completed the recommended course of 400,000 IU of oral ergocalciferol over 2 months, and only five (8%) responded with correction of their serum 25-OHD to the goal of 30 ng/ml or greater (mean change, +0.3 ng/ml; from 18.8 to 19.1 ng/ml). In the 33 adults with CF who also completed the recommended second course of 800,000 IU of ergocalciferol over 2 months, none demonstrated correction of their deficiency (mean change, -1.2 ng/ml).

Conclusion: The results of this study demonstrate that a majority of adults with CF have serum 25-OHD levels below 30 ng/ml, and the currently recommended ergocalciferol repletion regimen often does not fully correct vitamin D deficiency and may need to be revised to include even higher dosing of ergocalciferol. Further work is needed to establish the ideal 25-OHD level for maximizing calcium absorption and bone health in CF.

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