The effect of combined calcium and cholecalciferol supplementation on bone mineral density in elderly women with moderate chronic kidney disease

Aims: To examine the effect of combined calcium and vitamin D-3 supplementation on bone mineral density (BMD) in patients with chronic kidney disease (CKD). Methods: We performed a post-hoc analysis of the DECALYOS 11, a 2-year randomized, double-blind, placebo-controlled study of 610 women randomized to: calcium-vitamin D-3 fixed combination, calcium plus vitamin D-3 separate combination, or placebo. Both active treatment groups received the same daily amount of calcium (1,200 mg) and vitamin D-3 (800 IU). BMD of the distal radius was measured by single X-ray absorptiometry at baseline, 12 and 24 months. Results: At baseline 47.2%, 36.4% and 16.4% of the study population had an eGFR >= 60, 45 - 59, and < 45 ml/min/1.73 m(2), respectively. Both active regimens vs. placebo markedly increased serum 25-hydroxyvitamin D levels from baseline in all eGFR groups (p < 0.0001). Analysis of variance demonstrated an overall treatment effect on distal radius BMD (p = 0.005), with the active treatment groups showing a lower rate of BMD loss when compared to the placebo group. The effects of the intervention on BMD did not differ significantly according to baseline, eGFR (interaction p > 0.22 for all time points). Conclusion: Combined calcium and vitamin D-3 supplementation was effective in reducing rate of BMD loss in women with moderate CKD.