Electrolyte Blood Press.  2011 Jun;9(1):1-6. 10.5049/EBP.2011.9.1.1.

Vitamin D, and Kidney Disease

• Kim HS
• Chung W
• Kim S

• KMID: 1497135
• DOI: http://doi.org/10.5049/EBP.2011.9.1.1

Abstract

Mineral metabolism abnormalities, such as low 1,25-dihydroxyvitamin D (1,25(OH)2D) and elevated parathyroid hormone (PTH), are common at even higher glomerular filtration rate than previously described. Levels of 25-hydroxyvitamin D (25(OH)D) show an inverse correlation with those of intact PTH and phosphorus. Studies of the general population found much higher all-cause and cardiovascular (CV) mortality for patients with lower levels of vitamin D; this finding suggests that low 25(OH)D level is a risk factor and predictive of CV events in patients without chronic kidney disease (CKD). 25(OH)D/1,25(OH)2D becomes deficient with progression of CKD. Additionally, studies of dialysis patients have found an association of vitamin D deficiency with increased mortality. Restoration of the physiology of vitamin D receptor activation should be essential therapy for CKD patients.

Keyword

renal insufficiency, chronic; vitamin D; deficiency

MeSH Terms

Dialysis
Glomerular Filtration Rate
Humans
Kidney
Kidney Diseases
Parathyroid Hormone
Phosphorus
Receptors, Calcitriol
Renal Insufficiency, Chronic
Risk Factors
Vitamin D
Vitamin D Deficiency
Vitamins
Parathyroid Hormone
Phosphorus
Receptors, Calcitriol
Vitamin D
Vitamins

Figure

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  Fig. 1 Prevalence of Vitamin D Deficiency and Vascular Calcification in Stage 4 and 5 CKD. CKD, chronic kidney disease; 25(OH)D, 25-hydroxyvitamin D; white box, Adragao score6); gray box, Kauppila score7).*Data from the study of Garcia-Canton C et al. Ref. 5.

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  Fig. 2 Synthesis of Vitamin D. D2, vitamin D2; D3, vitamin D3; VDR, vitamin D receptor.*Modified from the study of Razzaque MS. Ref. 8.

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  Fig. 3 Function of Vitamin D Receptor (VDR) Conformational Ensemble: Genomic or Rapid Responses.*Modified from the study of Norman AW et al. Ref. 1.

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