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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Effects of Vitamin D Supplementation on Cardiovascular Outcomes in Chronic Kidney Disease Patients: A Systematic
Ayesha Saleem1, Suraj S Padakanti2, Mohsin Hajjaj3
1Internal Medicine, Jinnah Hospital Lahore, Lahore, PAK.
Insights
Vitamin D supplementation in chronic kidney disease (CKD) patients did not significantly impact cardiovascular events or heart function. Further research is needed to clarify vitamin D
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Endocrinology
Background:
- Conflicting data exist regarding vitamin D's cardiovascular benefits in chronic kidney disease (CKD).
- Understanding vitamin D's role is crucial for managing cardiovascular risk in CKD patients.
Purpose of the Study:
- To conduct a meta-analysis investigating the effect of vitamin D supplementation on cardiovascular outcomes in patients with CKD.
- To evaluate vitamin D's impact on adverse cardiovascular events, cardiac function (LVEF, LVMI), and blood pressure (SBP, DBP).
Main Methods:
- Systematic search of major databases (MEDLINE, Cochrane, Scopus, ClinicalTrials.gov) for randomized controlled trials (RCTs).
- Inclusion of 11 RCTs assessing vitamin D supplementation in CKD patients.
- Pooled analysis using risk ratios and mean differences for primary and secondary outcomes.
Main Results:
- Vitamin D supplementation showed a significant reduction in adverse cardiovascular events (RR 0.39; 95% CI 0.22 to 0.69).
- No significant differences were observed in left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), systolic blood pressure (SBP), or diastolic blood pressure (DBP).
Conclusions:
- Current evidence suggests vitamin D supplementation does not significantly affect cardiovascular events, cardiac function, or blood pressure in CKD patients.
- Further large-scale RCTs and mechanistic studies are required to elucidate the precise role of vitamin D in this population.
Abstract:
Vitamin D supplementation may have beneficial effects on cardiovascular outcomes in patients with chronic kidney disease (CKD), but the underlying data are conflicting. We conducted a meta-analysis to investigate the effect of vitamin D on cardiovascular outcomes in patients with CKD. We searched MEDLINE (via PubMed), the Cochrane Library, Scopus, and ClinicalTrials.gov from inception to 16 March 2024 for all randomized controlled trials (RCTs) assessing vitamin D supplementation in patients with CKD and reporting cardiovascular outcomes. Our primary outcomes were the incidence of adverse cardiovascular events and the change in left ventricular ejection fraction (LVEF) and left ventricular mass index (LVMI). Our secondary outcomes were the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP). Data were pooled using risk ratio (RR) and mean difference as the effect measures. A total of 11 RCTs were included in our review. Vitamin D supplementation reduced the risk of adverse cardiovascular events in patients with CKD (RR 0.39; 95% CI 0.22 to 0.69; I2=0). There was no significant difference in LVEF, LVMI, SBP, and DBP between the vitamin D and control groups. Vitamin D supplementation does not affect adverse cardiovascular events, LVEF, LVMI, SBP, and DBP. Further large-scale RCTs and mechanistic studies are needed to understand the potential benefits of vitamin D supplementation in this patient population.
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