Pleiotropic effects of vitamin D in chronic kidney disease

Published on Jan 30, 2016in Clinica Chimica Acta3.786
· DOI :10.1016/J.CCA.2015.11.029
Wen Chih Liu10
Estimated H-index: 10
(TMU: Taipei Medical University),
Chia-Chao Wu23
Estimated H-index: 23
(NDMC: National Defense Medical Center)
+ 5 AuthorsKun Chieh Yeh1
Estimated H-index: 1
Sources
Abstract
Low 25(OH)D levels are common in chronic kidney disease (CKD) patients and are implicated in all-cause mortality and morbidity risks. Furthermore, the progression of CKD is accompanied by a gradual decline in 25(OH)D production. Vitamin D deficiency in CKD causes skeletal disorders, such as osteoblast or osteoclast cell defects, bone turnover imbalance, and deterioration of bone quality, and nonskeletal disorders, such as metabolic syndrome, hypertension, immune dysfunction, hyperlipidemia, diabetes, and anemia. Extra-renal organs possess the enzymatic machinery for converting 25(OH)D to 1,25(OH)2D, which may play considerable biological roles beyond the traditional roles of vitamin D. Pharmacological 1,25(OH)2D dose causes hypercalcemia and hyperphosphatemia as well as adynamic bone disorder, which intensifies vascular calcification. Conversely, native vitamin D supplementation reduces the risk of hypercalcemia and hyperphosphatemia, which may play a role in managing bone and cardio–renal health and ultimately reducing mortality in CKD patients. Nevertheless, the combination of native vitamin D and active vitamin D can enhance therapy benefits of secondary hyperparathyroidism because of extra-renal 1α-hydroxylase activity in parathyroid gland. This article emphasizes the role of native vitamin D replacements in CKD, reviews vitamin D biology, and summarizes the present literature regarding native vitamin D replacement in the CKD population.
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References152
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#2Charles A. Inderjeeth (UWA: University of Western Australia)H-Index: 17
AbstractA dramatic and sustained surge in vitamin D test numbers has been attributed to the extraskeletal and probable intra/paracrine effects of vitamin D and not the important role of vitamin D in the regulation of extracellular calcium homeostasis and bone metabolism. This review summarizes recent data regarding the skeletal and extraskeletal effects of vitamin D, provides an overview of current methods of 25-hydroxyvitamin D measurement and includes the beneficial and adverse effects of vita...
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#1Wen Chih LiuH-Index: 10
#2Cai Mei Zheng (TMU: Taipei Medical University)H-Index: 13
Last. Kuo Cheng Lu (FJU: Fu Jen Catholic University)H-Index: 19
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The common causes of death in chronic kidney disease (CKD) patients are cardiovascular events and infectious disease. These patients are also predisposed to the development of vitamin D deficiency, which leads to an increased risk of immune dysfunction. Many extra-renal cells possess the capability to produce local active 1,25(OH)2D in an intracrine or paracrine fashion, even without kidney function. Vitamin D affects both the innate and adaptive immune systems. In innate immunity, vitamin D pro...
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#1Nan Zhu (SJTU: Shanghai Jiao Tong University)H-Index: 5
#2Jialin Wang (SJTU: Shanghai Jiao Tong University)H-Index: 2
Last. Weijie Yuan (SJTU: Shanghai Jiao Tong University)H-Index: 9
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AbstractChronic kidney disease (CKD) is a significant public health problem and Vitamin D deficiency is prevalent in CKD and might be associated with calcium and phosphate metabolism, cardiovascular disease, infections as well as the progress of kidney dysfunction. Emerging evidence implies that Vitamin D supplements may be of benefit to CKD. Based on existing laboratory and clinical evidence, this review intends to discuss the effectiveness of Vitamin D supplements and controversy in clinical p...
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#1J. Dayre McNally (U of O: University of Ottawa)H-Index: 9
#2Klevis Iliriani (Trinity College, Dublin)H-Index: 5
Last. Kusum Menon (Children's Hospital of Eastern Ontario)H-Index: 26
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#1Annick Massart (ULB: Université libre de Bruxelles)H-Index: 13
#2Frédéric DebelleH-Index: 9
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Background The 2009 KDIGO (Kidney Disease: Improving Global Outcomes) chronic kidney disease–mineral and bone disorder clinical practice guideline suggests correcting 25-hydroxyvitamin D 3 (25[OH]D) levels Study Design 2-center, double-blind, randomized, 13-week, controlled trial followed by a 26-week open-label study. Setting & Participants 55 adult maintenance hemodialysis patients with 25(OH)D levels Intervention Cholecalciferol, 25,000IU, per week orally versus placebo for 13 weeks, then 26 ...
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#1Vin Tangpricha (Emory University)H-Index: 70
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#2Robin M. Daly (University of Melbourne)H-Index: 54
Last. Peter R. Ebeling (University of Melbourne)H-Index: 87
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#1Michael Sze Ka Wong (Goethe University Frankfurt)H-Index: 4
#2Matthias S. Leisegang (Goethe University Frankfurt)H-Index: 20
Last. Ralf P. Brandes (Goethe University Frankfurt)H-Index: 88
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Background—Vitamin D deficiency in humans is frequent and has been associated with inflammation. The role of the active hormone 1,25-dihydroxycholecalciferol (1,25-dihydroxy-vitamin D3; 1,25-VitD3) in the cardiovascular system is controversial. High doses induce vascular calcification; vitamin D3 deficiency, however, has been linked to cardiovascular disease because the hormone has anti-inflammatory properties. We therefore hypothesized that 1,25-VitD3 promotes regeneration after vascular injury...
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Osteoporosis is defined as a condition of impairment in bone strength due to low bone mineral density and poor bone quality and predisposes individuals to an increased risk of fractures. Osteoporosis may coexist with chronic kidney disease−mineral and bone disorder (CKD-MBD) and osteoporotic fractures occur in all stages of CKD. Management of osteoporosis in CKD should consider the pathophysiology of both disorders. Diagnosis and management of osteoporosis in patients with stages 1-3 CKD and pat...
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Vitamin D supplements have increasingly been used for the treatment and prevention of osteoporosis. Historically, effects of the vitamin on the cardiovascular (CV) system have been proposed and demonstrated in the literature, including benefits on serum lipids. Although observational studies support an association between increased serum vitamin D levels and a favorable lipid profile, interventional studies have shown no effects. This review presents and analyzes all the related randomized contr...
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INTRODUCTION Calciphylaxis is a rare but potentially fatal disease commonly occurred in dialysis patients. Despite some previous studies on risk factors for calciphylaxis, there is still a lack of data from Chinese population. METHODS The retrospective matched case-control study about calciphylaxis was performed in Zhongda Hospital affiliated to Southeast University. The case group involved 20 hemodialysis patients who were newly diagnosed with calciphylaxis from October 2017 to December 2018. T...
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Abstract null null Diabetic kidney disease (DKD) is not only one of the main complications of diabetes, but also the leading cause of the end-stage renal disease (ESRD). The occurrence and development of DKD have always been a serious clinical problem that leads to the increase of morbidity and mortality and the severe damage to the quality of life of human beings. Controlling blood glucose, blood pressure, blood lipids, and improving lifestyle can help slow the progress of DKD. In recent years,...
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Long-term dialysis involves a chronic inflammatory state and produces a high prevalence of vitamin D deficiency. A clinical trial was conducted in hemodialysis with serum 25-hydroxyvitamin D (25[OH]D) level <30 ng/ml. The conventional-group (N = 35) and the high-dose group (N = 35) were treated with ergocalciferol according to the K/DOQI guidelines and double dosage of ergocalciferol from the recommendation for 8 weeks, respectively. The main outcomes were measured by serum 25[OH]D and interleuk...
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Globally, acute kidney injury (AKI) is associated with significant mortality and an enormous economic burden. Whereas iron is essential for metabolically active renal cells, it has the potential to cause renal cytotoxicity by promoting Fenton chemistry-based oxidative stress involving lipid peroxidation. In addition, 1,25-dihydroxyvitamin D3 (calcitriol), the active form of vitamin D, is reported to have an antioxidative role. In this study, we intended to demonstrate the impact of vitamin D on ...
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#1Mona Alshahawey (Ain Shams University)H-Index: 3
#2Radwa El Borolossy (Ain Shams University)H-Index: 3
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Abstract Background and aim Vascular calcification is an independent risk factor for cardiovascular diseases and all-cause mortality in end stage renal disease, and particularly in hemodialysis patients. Vitamin D deficiency has been shown to be associated with vascular calcification among this category of patients. Cholecalciferol or vitamin D3; the native inactivated 25-hydroxy vitamin D [25(OH)D], has been proposed to have a good impact on vascular calcification and vitamin D deficiency. Howe...
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#1Maryanne Machado da Silva Canhos (UNESP: Sao Paulo State University)H-Index: 1
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AbstractIntroduction: Low vitamin D levels are associated with mortality in hemodialysis (HD) patients; however, the serum vitamin D thresholds are unclear. This study aimed to identify the vitamin...
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