Implementing Evidence-Based Vitamin D Protocol in the Dialysis Clinic: An Educational Approach
Nephrol Nurs J . May-Jun 2020;47(3):239-265.
Chigozie Uko 1 2 3, Rose Utley 4 5
Vitamin D deficiency is prevalent among patients with chronic kidney disease (CKD) and even more pronounced in patients with kidney failure who are undergoing peritoneal dialysis and hemodialysis. This project was a nurse practitioner-led quality improvement project conducted in an outpatient hemodialysis unit that focused on determining if educating providers and hemodialysis unit clinical staff on vitamin D guidelines increased the awareness and monitoring of patients on hemodialysis. The number of patients screened for vitamin D levels increased from 29% to 100%,
and 70% of patients tested were deficient in vitamin D. While the follow-up monitoring yielded a result of only 32%, we recommend processes and structures for long-term sustainability, such as periodic re-education, reminders and prompts for conducting needed follow-up, continued outcome monitoring, and champions to support the ongoing processes and structures.
- Kidney Dialysis often filters out Vitamin D, a problem for vegetarians and others- Feb 2021
- Kidney diseases and COVID-19 – probably helped by Vitamin D etc. – Jan 19, 2021
- Chronic Kidney Disease decreases Vitamin D in 4 ways – Nov 2017
- Vitamin D testers have different test results if there is chronic kidney disease – Sept 2019
- More than 30 ng of vitamin D is sometimes needed (Kidney needs 50 ng) – March 2019
- But many Kidney doctors only consider < 20 ng to be low and are unaware of the importance of fully-activited vitamin D during kidney failure
- Poor kidneys rarely get enough or the right form of vitamin D – Feb 2019
Kidney category starts with
Kidney category listing hassee also Overview Kidney and vitamin D
Peritoneal dialysis in titles in Vitamin D Life (21 titles as of Oct 2021)
Search Vitamin D Life for kidney transplant 798 items as of June 2019
"Chronic Kidney Disease" OR CKD 874 items as of Jan 2018
Kidney Intervention trials using Vitamin D:
- 1,000 IU of vitamin D provides little benefit (Kidney transplant in this case) – April 2021
- Kidney patients who happened to be getting high-dose Calcitriol were 9X less likely to die of COVID-19 - April 6, 2021
- Chronic Kidney Disease (stage 3) slowed by 30 ng of Vitamin D and Calcitriol – Dec 2019
- Diabetic nephropathy (Kidney) treated by 50,000 IU of vitamin D weekly – RCT Jan 2019
- Hemodialysis patients (CKD) helped by weekly 50,000 IU of vitamin D – Jan 2017
- Kidney disease helped by active or high dose Vitamin D - Feb 2014
- Peritoneal Dialysis nicely treated by active vitamin D – July 2013
- 7100 IU (50000 weekly) restored vitamin D levels for those with Chronic Kidney Disease – July 2012
- Chronic Kidney Disease reduced with 3600 IU vitamin D (50000 twice a month)– RCT Aug 2012
- Overview Kidney and vitamin D
Overview Kidney and vitamin D contains the following summary
- FACT: The Kidneys are not the primary way to activate vitamin D, the tissues are
- FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
- FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
- FACT: There are many on-going intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
- FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
- FACT: 38% of seniors have Chronic Kidney Disease and most are unaware of it CDC statistics 2020
- FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
- Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
Calcitriol - which bypasses the need for the kidney to activate vitamin D
Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012 - Category Kidney and Vitamin D contains
208 items Vitamin D is needed during Dialysis – initially only 29 pcnt tested, extensive education raised it to 32 pcnt – May 2020Printer Friendly PDF this page! Follow this page for updates346 visitors, last modified 28 Feb, 2021, This page is in the following categories (# of items in each category)