Vitamin D kinetics in the acute phase of critical illness: A prospective observational study

Czarnik, Tomasz; Czarnik, Aneta; Gawda, Ryszard; Gawor, Maciej; Piwoda, Maciej; Marszalski, Maciej; Maj, Magdalena; Chrzan, Olimpia; Rahim, Said; Rusek-Skora, Maja; Ornat, Marta; Filipiak, Kamil; Stachowicz, Jakub; Kapłon, Robert; Czuczwar, Mirosław

doi:10.1016/j.jcrc.2017.09.179

Cited by 24 publications

(36 citation statements)

References 40 publications

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“…Although serum 25(OH)D concentrations were obtained one time within 24 hours of admission, the duration of illness prior to sample collection varied. Vitamin D concentrations in people decrease in the acute phase of critical illness and increase during recovery [ 17 ]. It is possible that sampling at a different time point would have yielded different results.…”

Section: Discussionmentioning

confidence: 99%

“…While vitamin D is classically thought of in the context of calcium, phosphorous, and skeletal homeostasis [ 14 – 16 ], identification of vitamin D receptors and 1-alpha hydroxylase in tissues outside of the kidney suggests more extensive effects than previously thought [ 16 ]. The pleiotropic effects of vitamin D extend to regulation of cell proliferation, angiogenesis, blood pressure, as well as the innate and adaptive immune systems [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Serum vitamin D concentrations in hospitalized critically ill dogs

et al. 2018

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Hypovitaminosis D has been extensively documented in critically ill humans. However, whether or not critically ill dogs have alterations in vitamin D concentrations remains unconfirmed. The primary aims of our study were to compare serum 25-hydroxycholecalciferol [25(OH)D] concentrations in critically ill dogs with healthy control dogs, determine the prognostic utility of serum 25(OH)D concentration as a biomarker in critically ill dogs, and to assess if serum 25(OH)D concentrations in critically ill dogs are associated with length of stay in the intensive care unit or illness severity. Serum concentrations of 25(OH)D together with a range of other clinical, biochemical, and hematological parameters, were measured in 99 dogs within 24 hours of admission to the Intensive Care Unit (ICU). Critically ill dogs (P = 0.001) and dogs with sepsis (P = 0.002) had significantly lower serum 25(OH)D concentrations compared to healthy control dogs. In addition, serum 25(OH)D concentration was an independent predictor of in-hospital and 30 day survival. Using a cut-off of 33 ng/mL, serum 25(OH)D concentrations had excellent sensitivity (0.94; 95% CI, 0.71–1.00), but poor specificity (0.41; 95% CI, 0.31–0.53) for detection of survival. Serum 25(OH)D concentrations were inversely associated with acute patient physiologic and laboratory evaluation (APPLE) fast score but were not associated with ICU length of stay. Hospitalized dogs with critical illness have decreased serum 25(OH)D concentrations compared to healthy dogs and can be used to predict survival in this cohort.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum vitamin D concentrations in hospitalized critically ill dogs

et al. 2018

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“…Vitamin D has also been linked to distinct components of the ageing process ( Figure 2). The negative acute phase reactant vitamin D [90] mitigates oxidative stress at least in part through increased expression of anti-oxidant regulators, including NRF2 and klotho [91][92][93]. Thus, calcitriol increased renal and circulating klotho expression, whereas it reduced markers of oxidative stress in uninephrectomized, spontaneously hypertensive rats [94].…”

Section: The Endocrine Phosphate-fgf-23-klotho Axis and Premature Agementioning

confidence: 99%

Inflammation and Premature Ageing in Chronic Kidney Disease

Ebert

Pawelzik

Witasp

et al. 2020

Toxins

150

122

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Persistent low-grade inflammation and premature ageing are hallmarks of the uremic phenotype and contribute to impaired health status, reduced quality of life, and premature mortality in chronic kidney disease (CKD). Because there is a huge global burden of disease due to CKD, treatment strategies targeting inflammation and premature ageing in CKD are of particular interest. Several distinct features of the uremic phenotype may represent potential treatment options to attenuate the risk of progression and poor outcome in CKD. The nuclear factor erythroid 2-related factor 2 (NRF2)–kelch-like erythroid cell-derived protein with CNC homology [ECH]-associated protein 1 (KEAP1) signaling pathway, the endocrine phosphate-fibroblast growth factor-23–klotho axis, increased cellular senescence, and impaired mitochondrial biogenesis are currently the most promising candidates, and different pharmaceutical compounds are already under evaluation. If studies in humans show beneficial effects, carefully phenotyped patients with CKD can benefit from them.

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“…In critical illness, there also is evidence of rapid falls in circulating 25(OH)D concentrations, potentially due to disrupted metabolism, fluid resuscitation, decreased synthesis of vitamin D-binding protein due to hepatic dysfunction, interstitial extravasation caused by increased vascular permeability, renal wasting of vitamin D, decreased renal conversion to 1,25(OH)D3 and increased tissue conversion of 25(OH)D3 to 1,25(OH)D3 ( 11 , 24 , 25 , 26 ). The role of free/bioavailable vitamin D remains unclear although it is possible that although vitamin D binding protein (VDBP) and thus total D decreases, circulating free D may be maintained ( 27 ).…”

Section: Vitamin D Status In Critically Ill Patientsmentioning

confidence: 99%

Vitamin D and critical illness: what endocrinology can learn from intensive care and vice versa

Amrein¹,

Papinutti

Mathew

et al. 2018

Endocrine Connections

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The prevalence of vitamin D deficiency in intensive care units ranges typically between 40 and 70%. There are many reasons for being or becoming deficient in the ICU. Hepatic, parathyroid and renal dysfunction additionally increases the risk for developing vitamin D deficiency. Moreover, therapeutic interventions like fluid resuscitation, dialysis, surgery, extracorporeal membrane oxygenation, cardiopulmonary bypass and plasma exchange may significantly reduce vitamin D levels. Many observational studies have consistently shown an association between low vitamin D levels and poor clinical outcomes in critically ill adults and children, including excess mortality and morbidity such as acute kidney injury, acute respiratory failure, duration of mechanical ventilation and sepsis. It is biologically plausible that vitamin D deficiency is an important and modifiable contributor to poor prognosis during and after critical illness. Although vitamin D supplementation is inexpensive, simple and has an excellent safety profile, testing for and treating vitamin D deficiency is currently not routinely performed. Overall, less than 800 patients have been included in RCTs worldwide, but the available data suggest that high-dose vitamin D supplementation could be beneficial. Two large RCTs in Europe and the United States, together aiming to recruit >5000 patients, have started in 2017, and will greatly improve our knowledge in this field. This review aims to summarize current knowledge in this interdisciplinary topic and give an outlook on its highly dynamic future.

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Vitamin D kinetics in the acute phase of critical illness: A prospective observational study

Cited by 24 publications

References 40 publications

Serum vitamin D concentrations in hospitalized critically ill dogs

Serum vitamin D concentrations in hospitalized critically ill dogs

Inflammation and Premature Ageing in Chronic Kidney Disease

Vitamin D and critical illness: what endocrinology can learn from intensive care and vice versa

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