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[Vitamin D and kidney diseases].
Étienne Cavalier1, Éric Thervet, Marie Courbebaisse
1CHU de Liège, service de chimie médicale, Liège, Belgique.
Presse Medicale (Paris, France : 1983)
|September 24, 2013
Summary
Vitamin D and its analogs offer protective benefits for chronic kidney disease (CKD) patients by reducing inflammation and proteinuria. Native vitamin D is safe for CKD patients, showing no increased risk of vascular calcification or renal stones.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Context:
- Chronic kidney disease (CKD) is associated with significant renal and cardiovascular complications.
- The renin-angiotensin system and NF-κB activation play critical roles in renal inflammation and fibrogenesis.
- Vitamin D's pleiotropic effects offer potential therapeutic benefits in CKD management.
Purpose:
- To review the multifaceted roles of calcitriol, vitamin D analogs, and native vitamin D in the context of chronic kidney disease.
- To evaluate the safety and efficacy of vitamin D administration in CKD patients, including its impact on mortality, proteinuria, inflammation, and fibrogenesis.
- To explore the potential of vitamin D analogs in renal transplantation.
Summary:
- Calcitriol and its analogs inhibit the renin-angiotensin system and NF-κB activation, mitigating glomerular and tubulo-interstitial damage, and reducing proteinuria in CKD.
- Native vitamin D (cholecalciferol or ergocalciferol) administration in CKD patients reduces parathyroid hormone levels and is associated with reduced mortality, antiproteinuric effects, and anti-inflammatory properties.
- Native vitamin D is safe in CKD patients, without increased risk of vascular calcification or renal stones, even at pharmacological doses when not combined with calcium salts.
Impact:
- Vitamin D supplementation represents a safe and effective strategy to manage CKD complications, improve patient outcomes, and reduce mortality.
- Further clinical studies are warranted to fully elucidate the protective role of vitamin D analogs in renal transplantation and acute rejection.
- Understanding vitamin D's pleiotropic effects can guide therapeutic interventions to improve the quality of life for CKD patients.
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