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Vitamin D Statement

 

Guiding Principles

Low dose vitamin D may help with the symptoms of fatigue, weakness and muscle loss.
Note: There is no evidence to support monitoring serum Parathyroid hormone (PTH) levels and therefore will not be routinely monitored unless otherwise indicated. Interventional guidelines do not replace individualized care and clinical expertise.

Vitamin D3

  • Some patients may be appropriate for vitamin D3 supplementation; however, there is a lack of consensus to support routine vitamin D3 supplementation in patients with CKD.

Calcitriol (active form of vitamin D, e.g. Rocaltrol)

  • Patients with CKD have reduced 1,25-dihydroxyvitamin D (1,25(OH)2D) activity and can receive an active vitamin D replacement (vitamin D analogue).
  • Based on their own clinical assessment, individual practitioners may recommend defined doses to address the potential role of active vitamin D delivery in fatigue, weakness, and muscle loss.
  • A suggested starting dose would be: calcitriol (Rocaltrol) 0.25 mcg PO 3 times a week.
  • See: Calcium Phosphorous Guideline
  • See: Fatigue/Sleep Guideline

Considerations at End of Life:

As a patient's condition deteriorates, the Vitamin D Statement is not considered to be relevant to their conservative kidney management.

Additional Resources:

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