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Role of vitamin d receptor activators in cardio-renal syndromes
Mario Cozzolino1, Elena Bruschetta, Andrea Stucchi
1Renal Division, Dipartimento di Medicina, Chirurgia e Odontoiatria, University of Milan School of Medicine, San Paolo Hospital, Milan, Italy. mario.cozzolino@unimi.it
Insights
Vitamin D deficiency is linked to heart problems, especially in chronic kidney disease patients. Supplementation may protect the heart and kidneys, potentially preventing cardio-renal syndrome.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Vitamin D deficiency is increasingly recognized for its role in cardiovascular morbidity and mortality.
- In chronic kidney disease (CKD), vitamin D levels decline due to renal impairment, exacerbating cardiovascular risks.
- CKD is associated with secondary hyperparathyroidism, hypocalcemia, hyperphosphatemia, and accelerated vascular calcification, contributing to left ventricular changes.
Purpose of the Study:
- To explore the association between vitamin D deficiency and cardiovascular outcomes in CKD patients.
- To investigate the impact of vitamin D administration on cardio-renal syndrome.
- To assess the potential of vitamin D in preventing cardiovascular and renal complications in CKD.
Main Methods:
- Review of recent studies and clinical data on vitamin D levels in CKD patients.
- Analysis of the effects of vitamin D supplementation on cardiovascular parameters and renal function.
- Evaluation of the role of vitamin D in managing secondary hyperparathyroidism and vascular calcification.
Main Results:
- Vitamin D deficiency is strongly associated with increased cardiovascular morbidity and mortality in CKD.
- Vitamin D administration shows potential cardioprotective and renoprotective effects.
- Supplementation may improve peripheral vascular disease, reduce vascular calcification, enhance cardiac outcomes, and aid blood pressure control.
Conclusions:
- Vitamin D deficiency significantly contributes to cardiovascular complications in chronic kidney disease.
- Vitamin D supplementation demonstrates promising benefits for cardiovascular and renal health in CKD.
- Vitamin D therapy may be crucial for preventing cardio-renal syndrome and its associated adverse outcomes.
Abstract:
The involvement of vitamin D deficiency in cardiovascular morbidity and mortality is attracting great interest. In patients with chronic kidney disease this association is stronger because vitamin D levels decrease as a result of renal progressive impairment. In chronic kidney disease secondary hyperparathyroidism commonly occurs in response to persistent hypocalcemia and hyperphosphatemia; moreover, parathyroid gland volume increases, vascular calcification is accelerated, and structural and functional modifications of the left ventricle are observed. These alterations entail both cardiac and renal involvement, resulting in cardio-renal syndrome. Recent studies concluded that vitamin D administration seems to have cardioprotective and renoprotective effects and improve peripheral vascular disease, vascular calcification, cardiac outcome, and blood pressure control. In clinical practice, therefore, the use of this hormone may play an important role in cardio-renal syndrome prevention.
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Role of Skin in Vitamin D Synthesis
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin D3(cholecalciferol).