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Dietary vitamin D intake in advanced CKD/ESRD
Ishir Bhan1, Martin Hewison, Ravi Thadhani
1Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. ibhan@partners.org
Seminars in Dialysis
|August 13, 2010
Summary
Vitamin D metabolism is altered in chronic kidney disease (CKD), impacting active vitamin D production. Emerging research highlights potential roles for vitamin D beyond the kidneys and its importance in managing CKD patients.
Area of Science:
- Nephrology
- Endocrinology
- Nutritional Science
Background:
- Healthy vitamin D metabolism involves liver and kidney conversion to active forms.
- Chronic kidney disease (CKD) impairs the kidney's ability to produce active vitamin D (1,25-dihydroxyvitamin D).
- Therapeutic focus in CKD has been replacing the active hormonal form of vitamin D to manage complications.
Purpose of the Study:
- To review vitamin D metabolism in the context of CKD.
- To explore emerging roles of vitamin D beyond traditional functions.
- To discuss the significance of nutritional vitamin D in CKD management.
Main Methods:
- Review of current literature on vitamin D metabolism.
- Analysis of research on extra-renal vitamin D conversion.
- Examination of clinical data linking 25-hydroxyvitamin D levels to CKD outcomes.
Main Results:
- CKD progressively reduces the capacity for active vitamin D synthesis.
- Extra-renal conversion of 25-hydroxyvitamin D may have significant biological functions.
- 25-hydroxyvitamin D levels are increasingly associated with clinical outcomes in CKD patients.
Conclusions:
- Understanding altered vitamin D metabolism is crucial for CKD management.
- Emerging roles of vitamin D, including extra-renal conversion, warrant further investigation.
- Nutritional vitamin D sources may play a vital role in managing CKD patients.
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