Abstract | BACKGROUND AND OBJECTIVES: STUDY DESIGN: We conducted a randomised controlled trial of 38 patients with non diabetic chronic kidney disease stage 3-4 and concomitant vitamin D deficiency (<16 ng/dl) who received oral ergocalciferol (50,000 IU weekly for one month followed by 50,000 IU monthly) or placebo over 6 months. The primary outcome was change in microcirculatory function measured by laser Doppler flowmetry after iontophoresis of acetylcholine. Secondary endpoints were tissue advanced glycation end products, sublingual functional capillary density and flow index as well as macrovascular parameters. Parallel in vitro experiments were conducted to determine the effect of ergocalciferol on cultured human endothelial cells. RESULTS: Twenty patients received ergocalciferol and 18 patients received placebo. After 6 months, there was a significant improvement in the ergocalciferol group in both endothelium dependent microcirculatory vasodilatation after iontophoresis of acetylcholine (p = 0.03) and a reduction in tissue advanced glycation end products (p = 0.03). There were no changes in sublingual microcirculatory parameters. Pulse pressure (p = 0.01) but not aortic pulse wave velocity was reduced. There were no significant changes in bone mineral parameters, blood pressure or left ventricular mass index suggesting that ergocalciferol improved endothelial function independently of these parameters. In parallel experiments, expression of endothelial nitric oxide synthase and activity were increased in human endothelial cells in a dose dependent manner. CONCLUSIONS: TRIAL REGISTRATION: Clinical trials.gov NCT00882401.
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Authors | Gavin Dreyer, Arthur T Tucker, Steven M Harwood, Rupert M Pearse, Martin J Raftery, Muhammad M Yaqoob |
Journal | PloS one
(PLoS One)
Vol. 9
Issue 7
Pg. e99461
( 2014)
ISSN: 1932-6203 [Electronic] United States |
PMID | 25006678
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Ergocalciferols
- Glycation End Products, Advanced
- Vitamins
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Topics |
- Administration, Oral
- Adult
- Comorbidity
- Drug Administration Schedule
- Ergocalciferols
(administration & dosage, therapeutic use)
- Female
- Glycation End Products, Advanced
(drug effects)
- Humans
- Kidney
(blood supply, drug effects, pathology)
- Male
- Microcirculation
(drug effects)
- Middle Aged
- Renal Insufficiency, Chronic
(drug therapy, physiopathology)
- Treatment Outcome
- Vitamin D Deficiency
(drug therapy, physiopathology)
- Vitamins
(administration & dosage, therapeutic use)
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