L15 Vitamin D Deficiency in Institutionalised HD Patients

Abstract

<h3>Background</h3> Elderly dementia patients are prescribed cholecalciferol (vitamin D) when institutionalized in one of our wards. We follow guidelines from the Dutch Health Council, which are evidence-based. No large-scale research, or guidelines are available on vitamin D deficiency and suppletion in institutionalized patient with HD, Korsakov’s syndrome or Acquired Brain Injury. Chel <i>et al</i>found high prevalence of vitamin D deficiency and insufficiency among 28 patients in a Dutch Skilled Nursing Facility. <h3>Method</h3> In 21 institutionalized HD patients we did blood tests to determine the level of vitamin D (serum 25(OH)D level). In these patients, blood samples had to be drawn for other indications, and the vit D level was assessed at the same time. <h3>Aim</h3> Assess the prevalence and level of vitamin D deficiency in our institutionalized HD patients. <h3>Results</h3> We found deficiency in all patients included. Mean was 25 nmol/l. Range was 3 – 51 nmol/l (rev. 50-150 nmol/l). Some of these patients are on a high kcal diet, adding drinks/meal replacements with added vitamins to their daily intake. <h3>Conclusions</h3> Vitamin D deficiency is common in advanced HD. <h3>Recommendations</h3> We recommend lab tests on admission, and prescribe monthly vitamin D to all HD patients with deficiency. In severe deficiency a weekly dose is given for three months. Contra indications (sarcoidosis, hyperkalemia, hyperparathyroidism) should be taken into account by prescribers. Exposure to the sun on a daily basis for at least 30 minutes is not always realistic, but advisable. <h3>References</h3> Chel VG, Ooms ME, van der Bent J, Veldkamp F, et al. High prevalence of vitamin D deficiency and insufficiency in patients with manifest Huntington disease: An explorative study. <i>Dermatoendocrinol</i>2013;5(3):348-51