Relationship between vitamin D and muscle size and strength in patients on hemodialysis

J Ren Nutr. 2007 Nov;17(6):397-407. doi: 10.1053/j.jrn.2007.06.001.


Objective: Vitamin D has various actions in skeletal muscle. The purpose of this study was to compare lower-limb muscle size and strength in hemodialysis (HD) patients being treated with 1,25-dihydroxyvitamin D (calcitriol) or a 1,25-dihydroxyvitamin D analogue (paricalcitol) with lower-limb muscle size and strength in HD patients who were receiving none.

Design: This was a retrospective, cross-sectional study.

Setting: This study was performed in outpatient HD centers.

Patients: Hemodialysis patients receiving calcitriol or paricalcitol (active vitamin D) for control of secondary hyperparathyroidism (VitD, n = 49) were compared with HD patients who were not (n = 30).

Main outcome measures: The main outcome measures included the cross-sectional areas (CSAs) of the thigh and tibialis anterior muscles by magnetic resonance imaging, and three measures of strength: the three-repetition maximum (3RM) for knee extension (isotonic), the peak torque of knee extensors (isokinetic), and maximal voluntary contraction of the ankle dorsiflexor muscles (isometric).

Results: There were no differences in age, weight, dialysis vintage, or intact parathyroid hormone levels between groups, although serum albumin was higher in the VitD group (P < .05). Patients in the VitD group had a larger thigh-muscle CSA (P < .05) and were stronger across all strength measures (P < .05) after controlling for age and gender (by analysis of covariance). When all analyses were subsequently adjusted for serum albumin concentration, only the difference in 3RM knee-extension strength lost significance. There were no significant differences in any measurements between patients who received calcitriol or paricalcitol.

Conclusion: Treatment with active vitamin D was associated with greater muscle size and strength in this cohort of HD patients.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Calcitriol / therapeutic use
  • Cohort Studies
  • Cross-Sectional Studies
  • Ergocalciferols / therapeutic use
  • Female
  • Humans
  • Hyperparathyroidism, Secondary / prevention & control
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Muscle Strength / drug effects*
  • Muscle Strength / physiology
  • Muscle, Skeletal / anatomy & histology
  • Muscle, Skeletal / drug effects*
  • Muscle, Skeletal / physiology*
  • Parathyroid Hormone / blood
  • Renal Dialysis* / adverse effects
  • Retrospective Studies
  • Serum Albumin / analysis
  • Serum Albumin / metabolism
  • Vitamin D / therapeutic use*


  • Ergocalciferols
  • Parathyroid Hormone
  • Serum Albumin
  • Vitamin D
  • paricalcitol
  • Calcitriol