Evaluation of impact of treatment with cholecalciferol on immunological markers in patients with vitamin D deficiency undergoing peritoneal dialysis

• Grant number: 12/10342-3
• Support Opportunities: Scholarships in Brazil - Doctorate
• Effective date (Start): August 01, 2012
• Effective date (End): July 31, 2015
• Field of knowledge: Health Sciences - Nutrition
• Principal Investigator: Lilian Cuppari
• Grantee: Marion Schneider Meireles
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Hypovitaminosis D is highly prevalent among patients with chronic kidney disease, especially those undergoing peritoneal dialysis (PD). In addition to the traditional risk factors for developing this condition, the loss of protein to the dialysis solution seems to contribute significantly to the reduced serum levels of vitamin D in patients on PD. As a result of the disease per se and the dialysis procedure, there is a high prevalence of chronic inflammation and high risk of infections, particularly of peritonitis among these patients. There is evidence in other populations that vitamin D has immunomodulatory effects by stimulating the production of cathelicidin, an antimicrobial peptide and suppressing the production of proinflammatory cytokines. Thus, in this study we aim to investigate the effects of cholecalciferol supplementation on immunological markers in patients with hypovitaminosis D on PD. This is a randomized, double-blind, placebo-controlled trial in which patients who have vitamin D deficiency [25(OH)D < 15 ng/mL] will be allocated to the intervention group (cholecalciferol) or control group (placebo). Supplemented patients will receive 50,000 IU/week of cholecalciferol for a period of 12 weeks. Before and after the intervention 25(OH)D, cathelicidin, interleukin-6 (IL-6), tumor necrosis factor-± (TNF-±) and C-reactive protein will be determined in serum as well as the expression of vitamin D receptor and 1-± hydroxylase enzyme will evaluates in monocytes.