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Vitamin d, and kidney disease.

Hyung Soo Kim1, Wookyung Chung, Sejoong Kim

  • 1Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.

Electrolyte & Blood Pressure : E & BP
|October 15, 2011
PubMed
Summary

Mineral metabolism abnormalities are common in chronic kidney disease (CKD) and linked to increased mortality. Early intervention with vitamin D therapy is crucial for CKD patients to restore physiological function.

Keywords:
deficiencyrenal insufficiency, chronicvitamin D

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Area of Science:

  • Nephrology
  • Endocrinology
  • Nutritional Science

Background:

  • Mineral metabolism abnormalities, including low 1,25-dihydroxyvitamin D and elevated parathyroid hormone, are prevalent in chronic kidney disease (CKD) patients.
  • Low 25-hydroxyvitamin D levels correlate with increased all-cause and cardiovascular mortality in the general population, suggesting a risk factor for cardiovascular events.

Purpose of the Study:

  • To highlight the commonality of mineral metabolism derangements in CKD.
  • To emphasize the association between vitamin D deficiency and mortality in CKD.
  • To advocate for vitamin D receptor activation as essential therapy in CKD.

Main Methods:

  • Review of existing literature on mineral metabolism in CKD.
  • Analysis of correlations between vitamin D metabolites, parathyroid hormone, and phosphorus levels.
  • Examination of mortality data in relation to vitamin D levels in CKD and general populations.

Main Results:

  • Mineral metabolism abnormalities occur even at higher glomerular filtration rates than previously recognized.
  • 25-hydroxyvitamin D levels inversely correlate with intact parathyroid hormone and phosphorus.
  • Vitamin D deficiency is linked to increased mortality in dialysis patients and is predictive of cardiovascular events in non-CKD populations.

Conclusions:

  • Vitamin D deficiency and its metabolites become progressively deficient with CKD progression.
  • Restoring vitamin D receptor activation physiology is essential for managing CKD patients.
  • Early recognition and management of mineral metabolism abnormalities are critical for improving outcomes in CKD.