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Shining light on vitamin D trials in chronic kidney disease
Sagar U Nigwekar1, Ravi I Thadhani
1Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Abstract:
Vitamin D compounds may have extraskeletal functions. Chronic kidney disease (CKD) offers an opportunity to investigate these actions, as vitamin D deficiency is prevalent in this population and actions of vitamin D such as those on the heart and glucose metabolism are highly relevant. However, recent randomized controlled trials have tempered enthusiasm. We appraise a trial by de Boer et al. that addresses effects of paricalcitol on glucose metabolism in CKD, and offer perspectives on future trials.
Insights
Vitamin D may impact more than bones, especially in chronic kidney disease (CKD). A recent study on paricalcitol and glucose metabolism in CKD patients provides new insights for future research.
Area of Science:
- Nephrology
- Endocrinology
- Metabolic Research
Background:
- Vitamin D compounds possess potential extraskeletal functions.
- Vitamin D deficiency is common in chronic kidney disease (CKD) patients.
- Extraskeletal actions of vitamin D on cardiovascular health and glucose metabolism are of significant interest in CKD.
Purpose of the Study:
- To appraise a randomized controlled trial by de Boer et al. investigating the effects of paricalcitol on glucose metabolism in CKD.
- To provide perspectives on the implications of these findings for future clinical trials in CKD.
Main Methods:
- Appraisal of a specific randomized controlled trial (de Boer et al.).
- Focus on the impact of paricalcitol, a vitamin D compound, on glucose metabolism.
- Analysis within the context of a chronic kidney disease population.
Main Results:
- Recent randomized controlled trials have yielded results that temper previous enthusiasm regarding vitamin D's extraskeletal benefits.
- The specific trial by de Boer et al. is examined for its findings on paricalcitol and glucose metabolism in CKD.
Conclusions:
- The study by de Boer et al. offers valuable data on the effects of paricalcitol in CKD patients.
- Further research and carefully designed future trials are needed to fully understand vitamin D's role in managing extraskeletal complications of CKD.
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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).

