The use of vitamin D analogs is independently associated with the favorable renal prognosis in chronic kidney disease stages 4–5: the CKD-ROUTE study

Arai, Yohei; Kanda, Eiichiro; Iimori, Soichiro; Naito, Seiji; Noda, Yumi; Kawasaki, Tomoki; Sato, Hidehiko; Ando, Ryoichi; Sasaki, Sei; Sohara, Eisei; Okado, Tomokazu; Rai, Tatemitsu; Uchida, Shinichi

doi:10.1007/s10157-016-1300-x

Cited by 7 publications

(6 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only in KTRs not receiving active vitamin D, low 1,25D levels were associated with poor outcome. To date, a small observational study among KTRs 29 , as well as a propensity-matched study of CKD 30 , suggests that active vitamin D therapy improves renal outcomes. Future randomized interventional studies are therefore warranted to assess the effect of active vitamin D use on graft outcome.…”

Section: Discussionmentioning

confidence: 99%

Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients

Doi

Hamano

Ichimaru

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Separate assessment of mineral bone disorder (MBD) parameters including calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D (1,25D) predict renal outcomes in kidney transplant recipients (KTRs), with conflicting results. To date, data simultaneously evaluating these parameters and interwoven relations on renal outcomes are scarce. We conducted a prospective long-term follow-up cohort study included 263 KTRs with grafts functioning at least 1 year after transplantation. The outcome was a composite of estimated GFR halving and graft loss. Cox regression analyses were employed to evaluate associations between a panel of six MBD parameters and renal outcomes. The outcome occurred in 98 KTRs during a median follow-up of 10.7 years. In a multivariate Cox analysis, intact PTH (iPTH), phosphate, and 1,25D levels were associated with the outcome (hazard ratio, 1.60 per log scale; 95% confidence interval, 1.19–2.14, 1.60 per mg/dL; 1.14–2.23 and 0.82 per 10 pg/mL; 0.68–0.99, respectively). Competing risk analysis with death as a competing event yielded a similar result. After stratification into four groups by iPTH and phosphate medians, high risks associated with high iPTH was not observed in KTRs with low phosphate levels (P-interaction < 0.1). Only KTRs not receiving active vitamin D, poor 1,25D status predicted the worse outcome (P-interaction < 0.1). High iPTH, phosphate, and low 1,25D, but not FGF23, levels predicted poor renal outcomes. Simultaneous evaluation of PTH and phosphate levels may provide additional information regarding renal allograft prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients

Doi

Hamano

Ichimaru

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Its deficiency increases the vulnerability to infections, increases generalized inflammation, increases risks for diseases and infections, and worsens chronic diseases [ 12 , 39 , 40 ]. Consequently, hypovitaminosis increases the susceptibility to infections and diseases and enhances the severity of illnesses [ 41 ], leading to increased complications and premature deaths [ 42 , 43 , 44 ]. Vitamin D has pleiotropic effects on body systems, especially the immune, musculoskeletal, cardiovascular, pulmonary, neurological, gastrointestinal, and renal systems.…”

Section: Consequences Of Vitamin D Deficiencymentioning

confidence: 99%

“…The importance of the above is highlighted by six positive respiratory tract infection-related RCTs, most conducted in children [ 42 , 43 , 57 , 58 , 59 ]; all of these used daily doses of vitamin D [ 101 , 102 , 134 ]. Another meta-analysis of RCTs on vitamin D supplementation in respiratory tract infections reported that vitamin D is most effective as a treatment when administered in daily doses than intermittently [ 135 ].…”

Section: What Has Changed Over the Years Related To Vitamin D?mentioning

confidence: 99%

Controlling Chronic Diseases and Acute Infections with Vitamin D Sufficiency

Wimalawansa

2023

Nutrients

View full text Add to dashboard Cite

Apart from developmental disabilities, the prevalence of chronic diseases increases with age especially in those with co-morbidities: vitamin D deficiency plays a major role in it. Whether vitamin D deficiency initiates and/or aggravates chronic diseases or vice versa is unclear. It adversely affects all body systems but can be eliminated using proper doses of vitamin D supplementation and/or safe daily sun exposure. Maintaining the population serum 25(OH)D concentration above 40 ng/mL (i.e., sufficiency) ensures a sound immune system, minimizing symptomatic diseases and reducing infections and the prevalence of chronic diseases. This is the most cost-effective way to keep a population healthy and reduce healthcare costs. Vitamin D facilitates physiological functions, overcoming pathologies such as chronic inflammation and oxidative stress and maintaining broader immune functions. These are vital to overcoming chronic diseases and infections. Therefore, in addition to following essential public health and nutritional guidance, maintaining vitamin D sufficiency should be an integral part of better health, preventing acute and chronic diseases and minimize their complications. Those with severe vitamin D deficiency have the highest burdens of co-morbidities and are more vulnerable to developing complications and untimely deaths. Vitamin D adequacy improves innate and adaptive immune systems. It controls excessive inflammation and oxidative stress, generates antimicrobial peptides, and neutralizes antibodies via immune cells. Consequently, vitamin D sufficiency reduces infections and associated complications and deaths. Maintaining vitamin D sufficiency reduces chronic disease burden, illnesses, hospitalizations, and all-cause mortality. Vulnerable communities, such as ethnic minorities living in temperate countries, older people, those with co-morbidities, routine night workers, and institutionalized persons, have the highest prevalence of vitamin D deficiency—they would significantly benefit from vitamin D and targeted micronutrient supplementation. At least now, health departments, authorities, and health insurance companies should start assessing, prioritizing, and encouraging this economical, non-prescription, safe micronutrient to prevent and treat acute and chronic diseases. This approach will significantly reduce morbidity, mortality, and healthcare costs and ensure healthy aging.

show abstract

“…In humans, the treatment with calcitriol in CKD patients promotes beneficial effects on the kidneys unrelated to PTH and mineral metabolism, including activity of renin-angiotensin-aldosterone system suppression, reduction of proteinuria, reduction of podocyte loss associated with glomerular hypertrophy and antiproliferative and antifibrotic effects [114][115][116][117]. These effects seem to be important to explain the benefits demonstrated by calcitriol therapy in CKD human patients, where it has been shown to limit the progression of CKD, improve survival and be independently associated with preservation of renal function [116,118].…”

Section: Effects Of Vitamin D On the Parathyroid Glandmentioning

confidence: 99%

The Role of Vitamin D in Small Animal Bone Metabolism

et al. 2020

View full text Add to dashboard Cite

Dogs and cats have differences in vitamin D metabolism compared to other mammalian species, as they are unable to perform vitamin D cutaneous synthesis through sun exposure. Therefore, they are dependent on the dietary intake of this nutrient. The classic functions of vitamin D are to stimulate intestinal calcium and phosphate absorption, renal calcium and phosphate reabsorption and regulate bone mineral metabolism. Thus, it is an important nutrient for calcium and phosphorus homeostasis. This review highlights the evidence of the direct and indirect actions of vitamin D on bone mineral metabolism, the consequences of nutritional imbalances of this nutrient in small animals, as well as differences in vitamin D metabolism between different size dogs.

show abstract

The use of vitamin D analogs is independently associated with the favorable renal prognosis in chronic kidney disease stages 4–5: the CKD-ROUTE study

Abstract: The use of vitamin D analogs is independently associated with the preservation of renal function in patients with pre-dialysis CKD stages 4-5.

Cited by 7 publications

References 34 publications

Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients

Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients

Controlling Chronic Diseases and Acute Infections with Vitamin D Sufficiency

The Role of Vitamin D in Small Animal Bone Metabolism

Contact Info

Product

Resources

About