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Published on: June 16, 2014
Effects of vitamin D on inflammatory state in patients with chronic kidney disease: A controversial issue
Liangbin Zhao1, Guoshuang Zhu2, Ling Wu1
1Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Insights
Vitamin D supplementation does not appear to reduce inflammation in chronic kidney disease (CKD) patients. Further large-scale trials are needed to confirm these findings regarding vitamin D and inflammation in CKD.
Area of Science:
- Nephrology
- Endocrinology
- Immunology
Background:
- The role of vitamin D in managing inflammation in chronic kidney disease (CKD) is not well-established.
- This study investigates the anti-inflammatory effects of vitamin D in CKD patients through a meta-analysis.
Approach:
- A comprehensive meta-analysis was conducted on randomized controlled trials (RCTs).
- Searches included major databases (Embase, Medline, etc.) and clinical trial registries.
- Subgroup analyses examined effects based on treatment duration, patient type, 25(OH)D levels, and CRP test methods.
Key Points:
- Eighteen trials involving 1834 CKD patients were analyzed.
- No significant differences in CRP, IL-6, or TNF-α levels were found between vitamin D and control groups.
- Vitamin D improved high-sensitivity CRP (hs-CRP) but not standard CRP levels.
Conclusions:
- Vitamin D supplementation does not demonstrate significant anti-inflammatory effects in CKD patients.
- High-sensitivity CRP showed improvement, suggesting a potential nuanced effect.
- More robust, large-scale RCTs are necessary to validate these findings and explore effective anti-inflammatory strategies for CKD.
Background:
The anti-inflammatory effect of vitamin D in patients with chronic kidney disease (CKD) remains controversial. This study aimed to conduct a meta-analysis of randomized controlled trials to assess the anti-inflammatory effects of vitamin D in patients with CKD.
Methods:
We searched Embase, Science Citation Index, Medline, Cochrane Central Register of Controlled Trials, and Clinical Trial Registries for randomized controlled trials that comparing vitamin D with control groups for inflammatory markers in patients with CKD. Subgroup analysis was performed based on treatment duration (short-term treatment, long-term treatment), type of patients (predialysis CKD, dialysis, kidney transplant), 25(OH)D levels (25(OH)D deficiency or normal 25(OH)D), and methods of C-reactive protein (CRP) test (standard CRP test or high-sensitivity CRP [hs-CRP] test).
Results:
Eighteen trials with 1834 patients were included in the present study. There were no significant differences between the vitamin D group and control group for CRP (WMD, -0.3 mg/L; 95% CI, -0.81 to 0.22, p = 0.26, I2 = 62%), interleukin-6 (IL-6) (WMD, -1.07 pg/ml; 95% CI, -2.44 to 0.30, p = 0.12, I2 = 52%), and tumor necrosis factor-α (TNF-α) (WMD, -0.00 pg/ml; 95% CI, -0.36 to 0.35, p = 0.99, I2 = 0%) in patients with CKD. Subgroup analysis showed vitamin D can improve hs-CRP, but not CRP. The rest of subgroups showed that no significant differences were observed between the vitamin D group and control group based on 25(OH)D levels, treatment duration, and predialysis CKD or dialysis patients.
Conclusion:
This meta-analysis demonstrates that vitamin D supplementation does not have anti-inflammatory effects in CKD patients. Well-designed randomized controlled trials with large samples are required to confirm this conclusion. It is still needed to find an effective treatment for inflammatory state in CKD.
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