ESPEN 2011 Late breaking abstract submission
Topic: Late Breaking Abstract
Abs n°:ESPEN11-2138
Abs Title: 25-HYDROXY-VITAMIN D, 1,25-DIHYDROXY-VITAMIN D, CALCIUM AND PHOSPHORUS IN PATIENTS ON LONG TERM HPN.
P. Thul 1,*K. Mielke 1
1Surgical Department, CHARITÉ, Berlin, Germany
Rationale: Patients on long term home parenteral nutrition (HPN) due to major surgery receive a vitamin preparation with a fixed combination of all vitamins without vitamin K. Bone disease has been a major complication of HPN.
Methods: 807 patients with HPN were treated since 1994 in the Surgical Department of Charité University hospital Berlin up to 16 years. Patients were on HPN for 224 086 days. In order to adopt HPN to the requirements of the patients, laboratory examinations were done every 2 months. Besides many other parameters Vitamin D, calcium and phosphorus were controlled. There are the data of 3081 blood tests up to April 2011.
Results: Hypovitaminosis D25 was seen in 71.8 % of specimen, mean value was 39.98 ± 27.1 nmol/l (ref. 50 – 250 nmol/l). The mean of 1,25-dihydroxy-vitamin D was 74.67 ± 49.2 pmol/l ( ref. 39 – 139 pmol/l), hypovitaminosis was measured in 23.6 % of specimen, hypervitaminosis in 9.1 %. Mean calcium was 2.26 ± 0.16 mmol/l (ref. 2.15 – 2.65 mmol/l). Hypocalcaemia was seen in 18.2 % of specimen. Mean phosphorus was 1.13 ± 0.25 mmol/l (ref. 0.8 – 1.5 mmol/l). Hypophosphataemia occured in 6.6 % and hyperphosphataemia in 6.2 % of the specimen. There were only 2 bone fractures due to accidents. Episodically kidney stones were seen in 3 patients who got extra Vitamin D by their familiar doctor due to low Vitamin D. There is some disagreement concerning the exact levels of 25-hydroxy-vitamin D needed for good health. The concentration 37.5 nmol/l is generally considered adequate.
Conclusion: Vitamin D deficiency is quite common in patients on HPN although vitamin supplementation was according to European and American guidelines. Low vitamin D and low calcium did not result in increased bone fracture rate. There is no hind that administration of more vitamin D results in better health of patients on parenteral nutrition.
Disclosure of Interest: None Declared
Keywords: None