Reprint of: Vitamin D receptor activation and prevention of arterial ageing

Area of Science:

• Nephrology
• Cardiology
• Endocrinology

Background:

• Patients with chronic kidney disease (CKD) exhibit significantly higher cardiovascular (CV) morbidity and mortality.
• Common comorbidities in CKD, including hypertension, diabetes, and mineral bone disease, contribute to elevated CV risk.
• Vitamin D deficiency is increasingly recognized as a critical factor exacerbating CV risk in the CKD population.

Purpose of the Study:

• To investigate the role of vitamin D deficiency and vitamin D receptor activators (VDRAs) in cardiovascular risk among CKD patients.
• To evaluate the potential ameliorative cardiovascular effects of selective VDRA, paricalcitol, compared to non-selective VDRA, calcitriol.

Main Methods:

• Review of recent data and investigations into vitamin D receptor (VDR) activation and its systemic effects.
• Analysis of the impact of calcitriol versus paricalcitol on serum calcium, phosphate levels, and associated cardiovascular risks.
• Exploration of paricalcitol's potential benefits on specific CKD complications linked to CV disease.

Main Results:

• Non-selective VDRA (calcitriol) is associated with increased serum calcium and phosphate, potentially worsening CV risk in CKD.
• Selective VDRA (paricalcitol) shows potential for ameliorative cardiovascular effects in CKD patients.
• Paricalcitol may positively impact diabetic nephropathy, cardiac disease, hypertension, and vascular calcification in CKD.

Conclusions:

• Vitamin D deficiency is a significant contributor to cardiovascular risk in chronic kidney disease.
• Selective VDRAs, such as paricalcitol, represent a promising therapeutic strategy to mitigate cardiovascular complications in CKD patients.
• Further research into paricalcitol may offer new avenues for managing cardiovascular disease in the context of chronic kidney disease.