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Efficacy of High-Dose Supplementation With Oral Vitamin D3 on Depressive Symptoms in Dialysis Patients With Vitamin D3 Insufficiency: A Prospective, Randomized, Double-Blind Study

Wang, Ying BS; Liu, Ying BS; Lian, Yueying BS; Li, Ning BS; Liu, Hong MD; Li, Guanzeng MS

Journal of Clinical Psychopharmacology: June 2016 - Volume 36 - Issue 3 - p 229–235
doi: 10.1097/JCP.0000000000000486
Original Contributions
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Psychological problems are common among end-stage renal disease patients undergoing dialysis. We aim to evaluate whether high-dose vitamin D3 (VD3) supplementation has beneficial effects on depressive symptoms in dialysis patients. This prospective, randomized, and double-blind trial includes 746 dialysis patients with depression treated in 3 hospitals in Southeast China. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders criteria. Patients were randomly assigned to 52-week treatment of oral 50,000 IU/wk VD3 (cholecalciferol) (test group) or a placebo (control group). The presence of depressive symptoms was evaluated using the Chinese version of Beck Depression Inventory (BDI) II both before and after treatment. Sociodemographic data, clinical data, nutritional indexes, inflammatory biomarkers, and plasma VD3 concentrations were also determined. Finally, 726 patients completed the experiments, including 362 tested patients and 364 controls. After 52 weeks, the depressive symptoms were not significantly improved in the test group (mean BDI II scores changed from −1.1 ± 0.3 to −3.1 ± 0.6) versus the control group. Multivariable logistic regression showed BDI scores were not significantly improved in the test group versus the control group with adjustment for age, sex, comorbidity index, dialysis modality, or (OH)D levels (multivariable-adjusted mean change or MAMC [95% confidence interval (CI)], −2.3 [−2.48 to −1.83]) in the whole dialysis population. After stratification by depression types, the findings do support a significant relationship between the VD3 supplementation and the improvement in BDI II scores in dialysis patients with vascular depression (MAMC [95% CI], −4.4 [−5.08 to −2.76]), but the effect was not significant for major depressive disorders (MAMC [95% CI], −0.9 [−1.52 to −0.63]). The high-dose VD3 supplementation did not significantly reduce the depressive symptoms in our total dialysis population, but a beneficial effect on vascular depression was found, probably mainly based on the improvement of cardiovascular risk factors.

From the Departments of *Internal Neurology, and †Radiotherapy, Liaocheng People's Hospital and Clinical School of Taishan Medical University; ‡Department of Internal Neurology, Dongchangfu District Hospital of Traditional Chinese Medicine; and §Department of Emergency Medicine, Liaocheng Hospital of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Liaocheng, Shandong, People's Republic of China.

Received March 28, 2015; accepted after revision February 11, 2016.

Ying Wang and Ying Liu contributed equally to this work.

Reprints: Ying Wang, BS, Department of Internal Neurology, Liaocheng People's Hospital and Clinical School of Taishan Medical University, No. 67, West Dongchang Road, Dongchangfu District, Liaocheng 252000, Shandong, People's Republic of China (e-mail: yyyy20142015@163.com).

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