Vitamin D3 Supplementation in Critically Ill Patients Undergoing CRRT
Status:
Not yet recruiting
Trial end date:
2026-01-01
Target enrollment:
Participant gender:
Summary
Patients hospitalized in intensive care units (ICU) are particularly susceptible to vitamin
D3 deficiencies. This can be due to the severity of their underlying disease, the type of
treatment they are on, malnutrition before and inadequate nutrition during the
hospitalisation preceding ICU admission, as well as advanced age. It has also been
established that plasma levels of 25(OH)D3 tend to systematically decrease during ICU
treatment. Therapeutic interventions administered in ICU settings such as fluid resuscitation
or extracorporeal therapies can cause additional vitamin D3 deficiencies. The incidence of
deficiency in critically ill patients can reach up to 90%, and even 30% of ICU patients can
have undetectable plasma levels. It is impossible to replenish vitamin D3 levels in
critically ill patients with traditional enteral and parenteral nutrition treatment regimens,
because nutritional products contain too little of the vitamin. Vitamin D3 deficiency in
critically ill patients has been associated with acute kidney injury, acute respiratory
failure, sepsis, septic shock and increased all-cause ICU mortality. Despite that, assessment
of plasma 25(OH)D3 levels is not a routine practice in ICUs. In view of the prevalence of
vitamin D3 deficiencies in ICU patients, rapid replenishment of this deficiency with an
increased supplementation dose should be considered as a potential means to improve prognosis
in this patient population. The current standard therapy is the administration of 500,000 IU
of vitamin D3 via the enteral route in ICU patients with severe deficiency (recommended by
ESPEN). The NephroD study is meant to help answer the question whether increasing the
standard ICU supplementation dose of vitamin D3 by 50% will ensure a more effective
replenishment of this vitamin in critically ill patients undergoing CRRT.
Phase:
Phase 4
Details
Lead Sponsor:
Uniwersytecki Szpital Kliniczny w Opolu
Treatments:
Cholecalciferol Ergocalciferols Vitamin D Vitamins