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Just 2 doses of Vitamin D resulted in many benefits (Chronic Kidney Disease)– Jan 2018

Vascular function and cholecalciferol supplementation in CKD: A self-controlled case series

The Journal of Steroid Biochemistry and Molecular Biology, online5 January 2018, https://doi.org/10.1016/j.jsbmb.2018.01.001
Vivek Kumara, , , Ashok Kumar Yadava, Manphool Singhalb, Vinod Kumara, Anupam Lalb, Debasish Banerjeec, d, Krishan Lal Guptaa, Vivekanand Jhaa, e, f

VitaminDWiki summary

Vitamin D given to 31 individuals having CKD– not a randomized controlled trial
cause of CKD was unknown in 50% of subjects.
Around 94% were hypertensive

Week 1 measurement, 300,000 IU dose
Week 8300,000 IU dose
Week 16 measurement


All of the following measurements had significant increases
1,25(OH)2D 1,25-Dihydroxyvitamin D
25(OH)D 25-Hydroxyvitamin D
FMD Endothelium dependent flow mediated dilatation
iFGF-23 Intact fibroblast growth factor-23
IL-6 Interleukin-6
iPTH Intact parathormone
NMD Endothelium independent nitroglycerine mediated dilatation
PWV Pulse wave velocity

See also VitaminDWiki


Overview Loading of vitamin D contains the following

If a person is, or is suspected to be, very vitamin D deficient a loading dose is typically given

  • Loading = repletion = quick replacement (previously known as Stoss)
  • Loading doses range in size from 100,000 IU to 1,000,000 IU of Vitamin D3
  • The size of the loading dose is a function of body weight - see below
    Unfortunately, some doctors persist in using Vitamin D2 instead of D3
  • Loading may be done as quickly as a single day, to as slowly as 3 months.
    It appears that spreading the loading dose over 4-20 days is a good compromise
  • Loading is typically oral, but sometimes by injection (I.M,)
  • The loading dose persists in the body for about 3 months
    The loading dose should be followed up with continuing maintenance
    Unfortunately, many doctors fail to follow-up with the maintenance dosing.
  • As about 1 in 300 people have some form of mild allergic reaction to vitamin D supplements,
    it appears prudent to test with a small amount of vitamin D before giving a loading dose
  • The causes of a mild allergic reaction appear to be: (in order of occurance)
    1) lack of magnesium - which can be easily added
    2) allergy to capsule contents - oil, additives (powder does not appear to cause any reaction)
    3) allergy to the tiny amount of D3 itself (allergy to wool) ( alternate: D3 made from plants )

Kidney category starts with

Kidney category listing has 169 items

see also Overview Kidney and vitamin D
Search VitaminDWiki for dialysis OR haemodialysis 477 items as of Jan 2018
Search VitaminDWiki for kidney transplant 469 items as of Jan 2018
"Chronic Kidney Disease" OR CKD 874 items as of Jan 2018

Calcitriol category listing has 39 items along with related searches


Kidney Intervention trials using Vitamin D:

Overview Kidney and vitamin D contains the following summary

  • FACT: Kidney is the primary way to activate vitamin D
  • FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
  • FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
  • FACT: There are many on-going intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
  • FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
  • FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
  • Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
      Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
    Calcitriol - which bypasses the need for the kidney to activate vitamin D
      Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
        Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012
  • Category Kidney and Vitamin D contains 169 items

The items in both Kidney and Loading Dose categories in VitaminDWiki are:


 Download the PDF from VitaminDWiki

Image

Highlights

  • Cholecalciferol supplementation in patients with CKD and vitamin D deficiency improved endothelial function (FMD) and vascular stiffness (PWV).
  • NMD also improved which is a novel finding and needs to be explored further.
  • PTH decreased with cholecalciferol supplementation.
  • FGF-23 also decreased with cholecalciferol supplementation unlike previously reported increase with use of activated vitamin D.

Vitamin D deficiency is common and associated with mortality in chronic kidney disease (CKD) patients. Cardiovascular disease (CVD) is the commonest cause of mortality in CKD patients. In a randomized, double blind, placebo controlled trial, we have recently reported favorable effects of vitamin D supplementation on vascular & endothelial function and inflammatory biomarkers in vitamin D deficient patients with non-diabetic stage 3-4 CKD (J Am Soc Nephrol 28: 3100–3108, 2017). Subjects in the placebo group who had still not received vitamin D after completion of the trial received two oral doses 300000 IU of oral cholecalciferol at 8 weeks interval followed by flow mediated dilatation (FMD), pulse wave velocity (PWV), circulating endothelial and inflammatory markers (E-Selectin, vWF, hsCRP and IL-6), 1,25 (OH)2D, iPTH and iFGF-23 assessment at 16 weeks. 31 subjects completed this phase of the study. Last values recorded in the preceding clinical trial were taken as baseline values. Serum 25(OH)D and 1,25(OH)2D increased and FMD significantly improved after cholecalciferol supplementation [mean change in FMD%: 5.8% (95% CI: 4.0-7.5%, p<0.001]. Endothelium independent nitroglycerine mediated dilatation, PWV, iPTH, iFGF-23 and IL-6 also showed favorable changes. The data further cement the findings of beneficial effects of correction of vitamin D deficiency on vascular function.

Created by admin. Last Modification: Thursday January 25, 2018 23:15:22 UTC by admin. (Version 10)

Attached files

ID Name Comment Uploaded Size Downloads
9255 Vascular function and cholecalciferol supplementation in CKD.pdf PDF 2018 admin 25 Jan, 2018 23:08 153.14 Kb 40
9139 300,000.jpg admin 06 Jan, 2018 13:19 145.98 Kb 77
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