Primary care management of vitamin D deficiency and liver disease

PurposeVitamin D deficiency is one of the most common medical conditions. Up to 96% of patients with liver disease have this deficiency. The purpose of this manuscript is to educate primary care nurse practitioners (NPs) of vitamin D deficiency and its proper management in patients with liver disease. Data sourcesInformation was compiled by reviewing the scientific literature on cirrhosis, liver disease, and vitamin D deficiency (CINAHL, MEDLINE, PubMed search engines). ConclusionsWhile the usual supplement dose for vitamin D deficiency is 1000 international units (vitamin D-3) daily, vitamin D-2 supplementation at doses of 50,000 international units can be given for correction. Primary care NPs can assist patients with liver disease with optimal nutrition and vitamin supplementation. Implications for practicePrimary care NPs should be aware of vitamin D deficiency in patients with liver disease. Vitamin D supplementation may be required in high doses in those patients with a moderate to severe deficiency. Repeat 25-hydroxyvitamin D levels should be checked after supplementation is completed and yearly thereafter.