Vitamin D deficiency in patients receiving home parenteral nutrition

JPEN J Parenter Enteral Nutr. 2011 Jul;35(4):499-504. doi: 10.1177/0148607110381269. Epub 2011 May 3.


Background: In addition to its role in bone metabolism, vitamin D has important immunomodulatory and antineoplastic effects. Patients on home parenteral nutrition (HPN) receive most of their vitamin D from intravenous (IV) supplementation. Vitamin D deficiency is common in the general population, and the adequacy of vitamin D supplementation in HPN patients is unclear. The purpose of this study is to determine the vitamin D status of patients on HPN.

Methods: Consecutive patients seen in a regional home nutrition program had their oral and IV vitamin D intakes determined. Plasma 25-hydroxyvitamin D levels were measured in all patients. Intake of calcium, magnesium, and phosphate were also determined.

Results: The mean 25-hydroxyvitamin D level in 22 patients receiving HPN for a mean of 33.5 months (range, 1-177) was 42 nmol/L. Vitamin D deficiency was present in 15 (68%) patients and vitamin D insufficiency in 6 (27%) patients. The mean dietary vitamin D intake was 79.5 IU per day, while the mean IV supplementation was 166 IU per day.

Conclusions: In this study of a regional Canadian HPN program, there was a high prevalence of vitamin D deficiency/insufficiency affecting virtually all patients. All patients receiving HPN should be supplemented with vitamin D and have their 25-hydroxyvitamin D levels monitored. Further studies are required to determine optimal methods and dosing of vitamin D replacement using oral supplements or ultraviolet light therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Calcium, Dietary / administration & dosage
  • Canada
  • Dietary Supplements
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parenteral Nutrition, Home / adverse effects*
  • Parenteral Nutrition, Home / methods
  • Prevalence
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / epidemiology*
  • Vitamins / blood
  • Young Adult


  • Calcium, Dietary
  • Vitamins
  • Vitamin D
  • 25-hydroxyvitamin D