Prevalence of Vitamin D Deficiency and Response to Oral Vitamin D Supplementation in Patients Receiving Home Parenteral Nutrition
Journal of Parenteral and Enteral Nutrition, 06/25/2012
Clinical Article
Kumar PR et al. – Most patients receiving home parenteral nutrition (HPN) had insufficient vitamin D status. When prescribed high doses of oral vitamin D, patients did not consistently achieve appropriate 25OHD levels. Alternate routes of vitamin D supplementation in patients receiving HPN should be considered. Large multicenter prospective studies are needed to best characterize the relationship between vitamin D dosing for HPN patients and vitamin D status.
Methods- A retrospective chart review of eligible adults enrolled in the Southern Alberta Home Parenteral Nutrition program (n=15) for a minimum of 6 months was conducted.
- Serum measurements of 25OHD were recorded and patients were categorized by vitamin D status as follows: sufficient; insufficient; deficient with respective levels of 25OHD ≥75 nmol/L, 27.5-75 nmol/L, and ≤27.5 nmol/L; and mixed.
- Five of 15 patients had insufficient vitamin D status throughout the study period; all had short bowel syndrome.
- Nine were in the mixed category; 1 was consistently sufficient, and no one was consistently deficient.
- Patient demographics were similar between the insufficient and mixed groups.
- There were no significant differences in health outcomes between the insufficient and mixed vitamin D status groups.
- The median (interquartile range) dose and duration of vitamin D3 supplementation for the insufficient group was 5000 IU/d (4,000-7,143) for 1,175 (1,145-1,578) total days compared to 3,000 IU/d (1,000-7,143) for 1,529 (111-1,980) days for the mixed group.
