The effect of combined calcium and cholecalciferol supplementation on bone mineral density in elderly women with moderate chronic kidney disease

Abstract

Aims: To examine the effect of combined calcium and vitamin D3 supplementation on bone mineral density (BMD) inpatients with chronic kidney disease (CKD).

Methods: We performed a post-hoc analysis of the DECALYOS II, a 2-year randomized, double-blind, placebo-controlled study of 610 women randomized to: calcium-vitamin D3 fixed combination, calcium plus vitamin D3 separate combination, or placebo. Both active treatment groups received the same daily amount of calcium (1,200 mg) and vitamin D3 (800 IU). BMD of the distal radius was measured by single X-ray absorptiometry at baseline, 12 and 24 months.

Results: At baseline 47.2%, 36.4% and 16.4% of the study population had an eGFR ≥ 60, 45 -59, and < 45 ml/min/1.73 m2, respectively. Both active regimens vs. placebo markedly increased serum 25-hydroxyvitamin D levels from baseline in all eGFR groups (p 0.22 for all time points).

Conclusion: Combined calcium and vitamin D3 supplementation was effective in reducing rate of BMD loss in women with moderate CKD.

Figure 1.. Effect of treatments on serum 25-hydroxyvitamin D levels per estimated glomerular filtration rate (eGFR) (p < 0.0001 for treatment effect). A: eGFR < 45 ml/min/1.73 m. Number of participants on each treatment arm (placebo, Ca + D, Ca-D) at baseline, 12 and 24 months were n = 100 (38, 36, 26), n = 78 (30, 27, 21) and n = 66 (28, 20, 18), respectively. B: eGFR 59 – 45 ml/min/1.73 m. Number of participants on each treatment arm (placebo, Ca + D, Ca-D) at baseline, 12 and 24 months were n = 222 (70, 73, 79), n = 182 (49, 66, 67) and n = 172 (48, 57, 67), respectively. C: eGFR ≥ 60 ml/min/1.73 m. Number of participants on each treatment arm (placebo, Ca + D, Ca-D) at baseline, 12 and 24 months were n = 288 (97, 90, 101), n = 250 (84, 79, 87) and n = 234 (76, 78, 80), respectively.

Figure 2.. Effect of treatments on bone mineral density (BMD) of the distal radius per estimated glomerular filtration rate (eGFR) (p = 0.005 for treatment effect). A: eGFR < 45 ml/min/1.73 m. Number of participants on each treatment arm (placebo, Ca + D, Ca-D) at baseline, 12 and 24 months were n = 100 (38, 36, 26), n = 78 (30, 27, 21) and n = 66 (28, 20, 18), respectively. B: eGFR 59 – 45 ml/min/1.73 m. Number of participants on each treatment arm (placebo, Ca + D, Ca-D) at baseline, 12 and 24 months were n = 222 (70, 73, 79), n = 182 (49, 66, 67) and n = 172 (48, 57, 67), respectively. C: eGFR ≥ 60 ml/min/1.73 m. Number of participants on each treatment arm (placebo, Ca + D, Ca-D) at baseline, 12 and 24 months were n = 288 (97, 90, 101), n = 250 (84, 79, 87) and n = 234 (76, 78, 80), respectively.