Pleiotropic effects of vitamin D in chronic kidney disease

Liu, Wen-Chih; Wu, Chia Chao; Hung, Yao Min; Liao, Min; Shyu, Jia Fwu; Lin, Yuh Feng; Lu, Kuo Cheng; Yeh, Kun Chieh

doi:10.1016/j.cca.2015.11.029

Cited by 43 publications

(44 citation statements)

References 141 publications

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“…In addition, vitamin D has multiple pleiotropic effects including regulating cell growth, differentiation and immunity, anti-inflammatory response, neuron health, insulin secretion and lipid metabolism [87,88]. Vitamin D deficiency in patients with and without CKD is associated with increased mortality [89,90].…”

Section: Derangements Of Bone Mineral Metabolismmentioning

confidence: 99%

Electrolyte and Acid-Base Disorders in Chronic Kidney Disease and End-Stage Kidney Failure

Dhondup

Qian²

2017

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150

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The kidneys play a pivotal role in the regulation of electrolyte and acid-base balance. With progressive loss of kidney function, derangements in electrolytes and acid-base inevitably occur and contribute to poor patient outcomes. As chronic kidney disease (CKD) has become a worldwide epidemic, medical providers are increasingly confronted with such problems. Adequate diagnosis and treatment will minimize complications and can potentially be lifesaving. In this review, we discuss the current understanding of the disease process, clinical presentation, diagnosis and treatment strategies, integrating up-to-date knowledge in the field. Although electrolyte and acid-base derangements are significant causes of morbidity and mortality in CKD and end-stage renal disease patients, they can be effectively managed through a timely institution of combined preventive measures and pharmacological therapy. Exciting advances and several upcoming outcome trials will provide further information to guide treatment and improve patient outcomes.

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Section: Derangements Of Bone Mineral Metabolismmentioning

confidence: 99%

Electrolyte and Acid-Base Disorders in Chronic Kidney Disease and End-Stage Kidney Failure

Dhondup

Qian²

2017

Blood Purif

150

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“…The number of patients who achieved the target level was significantly increased in the study group from the 8th week of supplementation (Table 3). Clinical studies of dialysis patients with SHPT also reported that the combined use of nutritional vitamin D might reduce the active vitamin D doses required for SHPT control and related adverse effects [2,31,32]. However, studies on the effective dosage of vitamin D supplementation for SHPT remain controversial [33,34,35].…”

Section: Discussionmentioning

confidence: 99%

Cholecalciferol Additively Reduces Serum Parathyroid Hormone and Increases Vitamin D and Cathelicidin Levels in Paricalcitol-Treated Secondary Hyperparathyroid Hemodialysis Patients

et al. 2016

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Background: Active Vitamin D analogues are used clinically for prevention and treatment of secondary hyperparathyroidism (SHPT) in hemodialysis (HD) patients. Nutritional vitamin D supplementation is used for additional local parathyroid (PTH) suppression, with lower incidence of hypercalcemia and hyperphosphatemia. This study evaluates the possible beneficial effects of combined vitamin D treatment (paricalcitol and cholecalciferol). Methods: Sixty HD patients with serum parathyroid hormone (iPTH) >300 pg/mL were enrolled. All patients administered 2 mcg/day of paricalcitol and were randomly allocated into control group (placebo) or study group (cholecalciferol) for 16 weeks. Serum 25(OH)D3, iPTH and human cathelicidin (hCAP-18) were measured at baseline and during follow-up. Results: iPTH levels decreased in the study group appropriately and were more significantly decreased at 16 weeks. Study group had significantly increased 25(OH)D3 levels. In addition, the study group had significantly increased serum hCAP-18 levels compared with control group. Correlation analysis showed a significant correlation between the percentage increase in serum hCAP-18 and 25(OH)D3 levels. Conclusions: Cholecalciferol, in combination with paricalcitol, additively lowers the iPTH levels in a significant number of patients after 16 weeks of supplementation. A dose of 5000 IU/week of cholecalciferol could maintain serum 25(OH)D3 levels above 30 ng/dL as early as 8 weeks after beginning supplementation. Doubling of serum cathelicidin levels were noted after 16 weeks of cholecalciferol supplementation in 40% of study patients.

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“…FGF-23 inhibits 1-α-hydroxylase activity in the renal proximal tubule and reduce active Vitamin D production and stimulates 24- [132]. In the same time, lower concentration of Vitamin D, as the case in CKD patients, will decrease the activity of 1-α-hydroxylase [126].…”

Section: Vitamin D and Kidney Diseasementioning

confidence: 99%

“…Patients with CKD have two problems; a high rate of severe Vitamin D and reduced ability to convert Vitamin D to active Vitamin D [124]. Vitamin D deficiency is observed in nearly all CKD patients; therefore, Vitamin D is recommended to be prescribed for stage 3-5 CKD patients who have low Vitamin D and high serum PTH levels [125,126] Many mechanisms were postulated to explain the decrease in Vitamin D during the course of CKD [126]. First, Low Vitamin D in a substrate-product relationship [127].…”

Section: Vitamin D and Kidney Diseasementioning

confidence: 99%