Vitamin D Therapy in Chronic Kidney Disease and End Stage Renal Disease

Melamed, Michal L.; Thadhani, Ravi

doi:10.2215/cjn.04040411

Cited by 106 publications

(85 citation statements)

References 68 publications

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“…Low level of vitamin D3 is associated with osteoporosis, rickets, cardiovascular disorder, some autoimmune disease, multiple sclerosis, diabetes mellitus and some cancers (9). It has been suggested that low level of vitamin D decreases the survival of general population and CKD and HD patients (10,11). Recent observations showed a positive relation between level of 25(OH)D and 1.25(OH)2 D in CKD patients (8,12,13).…”

Section: Discussionmentioning

confidence: 99%

“…Then at the base line we evaluated the relations between the serum level of vitamin D3 with blood level of PTH, Ca, P, ALP and CA × P product; then effect of administration of vitamin D3 on these biochemical markers was investigated. Melamed and Thadhani reported that there is an association between stage of CKD and vitamin D deficiency (11). This association is probably related to poor appetite, protein restriction, activity loss and less exposure to sunlight (11).…”

Section: Discussionmentioning

confidence: 99%

“…Melamed and Thadhani reported that there is an association between stage of CKD and vitamin D deficiency (11). This association is probably related to poor appetite, protein restriction, activity loss and less exposure to sunlight (11). Many studies have shown 25(OH) D values are less than 30 ng/mL in patients with CKD and ESRD (13,15,16).…”

Section: Discussionmentioning

confidence: 99%

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Relationship of circulating levels of 25(OH)D with parathyroid hormone in various stages of chronic kidney disease

Jalalzadeh¹,

Mousavinasab²,

Rostami³

2017

J Renal Inj Prev

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In a study on 115 patients with stages 2 to 5 CKD and the age of more than 14 years old, we found vitamin D deficiency as the serum level of 25 (OH)D3 <30 ng/mL, is common in CKD patients. There was a positive correlation between the serum levels of 25(OH)D3 and levels of PTH. The findings indicated that administration of vitamin D3 in all CKD patients with vitamin D deficiency was effective in reducing the serum levels of PTH. Please cite this paper as: Introduction:Vitamin D deficiency is common in both general population and chronic kidney disease (CKD) patients. Objectives: The aim of this study was to compare 25(OH)D3 levels in stages 2 to 5 of CKD patients and to evaluate whether inactive vitamin D supplement could prevent increasing of serum PTH levels. Patients and Methods: A total of 58 stages 2-4 CKD and 57 stage 5 CKD hemodialysis (HD) patients who had 25(OH)D3 <30 ng/mL were considered. All cases were under appropriate treatment for preventing secondary hyperparathyroidism. At the beginning, serum levels of vitamin D3, intact parathyroid hormone (iPTH), calcium (Ca), phosphate (P), alkaline phosphate (ALP) and albumin were measured. Patients received 300 000 IU/IM vitamin D3 and after 2 months this dosage was repeated, if it was necessary. All biochemical markers were checked and the effect of vitamin D3 was evaluated. Results: At base line, serum levels of 25(OH)D3 and PTH in patients with stages 2 to 5 of CKD were; 14.85±7.8 ng/mL (stage 2), 70.8 ± 16.8 pg/mL (stage 2); 16.48 ± 7.8 ng/mL (stage 3), 69.6 ± 39.2 pg/mL (stage 3); 16.33 ± 8.1 ng/mL (stage 4), 123.74 ± 92.5 pg/mL (stage 4); and 13.86 ± 6.5 ng/mL (stage 5) and 567.23 ± 276.7 pg/mL (stage 5), respectively. Two months after injections, 25(OH)D3 and PTH were changed as follow; 28.62 ng/mL (P = 0.001) (stage 2), 59.38 pg/mL (P = 0.34) (stage 2); 37.79 ng/mL (P < 0.001) (stage 3), 62.41 pg/ml (P = 0.18) (stage 3); 31.14 ng/mL (P = 0.001) (stage 4), 91.02 ± 69.4 pg/mL (P = 0.003) (stage 4) and 48.48 ng/mL (P < 0.001) (stage 5) and also 282.77 pg/mL (P < 0.001) (stage 5), respectively. Conclusion: The result of this study showed the vitamin D3 levels increased in all stages after 2 months. Also, the findings indicated that administration of vitamin D3 in all patients of the study groups reduced serum PTH levels. However, the rate of reduction was higher in stages 4 and 5 of CKD as compared to stages 2 and 3 of CKD (P < 0.001).This result encourages us to prescribe supplement vitamin D3 if the level is less than 30 ng/mL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Relationship of circulating levels of 25(OH)D with parathyroid hormone in various stages of chronic kidney disease

Jalalzadeh¹,

Mousavinasab²,

Rostami³

2017

J Renal Inj Prev

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“…5 Treatment with vitamin D in patients with CKD improves their long-term survival and reduces their cardiovascular risk. 10,11 T h e c i r c u l a t i n g l e v e l o f 25-hydroxy-vitamin D (25(OH)D) is the best marker of a subject's status in terms of vitamin D levels based on its prolonged circulation half-life and the fact that it does not build up in tissues. The measurement of 25(OH)D reflects vitamin D dietary intake, vitamin D produced in the skin from exposure to sunlight, and vitamin D made in the liver from adipose tissue deposits.…”

Section: Introductionmentioning

confidence: 99%

“…3 H o w e v e r , l e v e l s m a y v a r y depending on the season, duration of exposure to sunlight, sunscreen use, dietary intake, and urinary loss of vitamin D binding protein. 10,11 Studies have been conducted worldwide to establish vitamin D deficiency prevalence among children 16 The objectives of this study included establishing the prevalence of vitamin D deficiency among children with CKD and identifying associated risk factors and the relationship with parathormone (PTH) intact molecule.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of vitamin D deficiency among children with chronic kidney disease and kidney transplant

et al. 2017

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The effect of vitamin D supplementation on fibroblast growth factor‐23 in patients with chronic kidney disease: A systematic review and meta‐analysis

Karimi

Bitarafan

Mousavi

et al. 2021

Phytotherapy Research

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This is a meta-analysis of randomized controlled trials (RCTs) investigating the effects of oral vitamin D supplementation on serum fibroblast growth factor-23 (FGF23) concentrations in patients with chronic kidney disease (CKD). Manuscripts were extracted from PubMed/MEDLINE, Scopus, and ISI Web of Science through February 2020. Subgroup analyses, sensitivity analysis, and meta-regression assessments were performed. A total of eight clinical trials with nine treatment arms were included in the final analysis. The pooled results showed no significant changes in circulating FGF23 following vitamin D supplementation compared to the control group (Standardized mean difference (SMD): 0.24; 95% confidence intervals (CIs): À0.03 to 0.50, p > 0.05). Subgroup analyses found that studies which had participants with a body mass index (BMI) higher than 25 kg/m 2 , with an intervention duration shorter than 15 weeks, using phosphate binder medications, and trials that were on both patients with CKD undergoing hemodialysis and patients without hemodialysis treatment produced significant increases in FGF23 when concentration compared with the control group. This meta-analysis provides evidence that vitamin D supplementation does not have a significant effect on plasma FGF23 levels. However, further high-quality trials are required to identify the influence of oral vitamin D supplementation on FGF23 levels in patients with CKD. K E Y W O R D S chronic kidney disease, fibroblast growth factor-23, meta-analysis, vitamin D 1 | INTRODUCTION Patients with chronic kidney disease (CKD) experience a progressive and irreversible loss of renal function characterized by decreased glomerular filtration rate or increases in kidney failure biomarkers (Levin et al., 2013). Elevated fibroblast growth factor-23 (FGF23) is a common manifestation of impaired phosphate excretion in patients with CKD. High serum FGF23 concentrations are associated with

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Vitamin D Therapy in Chronic Kidney Disease and End Stage Renal Disease

Cited by 106 publications

References 68 publications

Relationship of circulating levels of 25(OH)D with parathyroid hormone in various stages of chronic kidney disease

Relationship of circulating levels of 25(OH)D with parathyroid hormone in various stages of chronic kidney disease

High prevalence of vitamin D deficiency among children with chronic kidney disease and kidney transplant

The effect of vitamin D supplementation on fibroblast growth factor‐23 in patients with chronic kidney disease: A systematic review and meta‐analysis

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