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Vitamin D for kidney disease – use native or active form – Jan 2016

Pleiotropic effects of vitamin D in chronic kidney disease.

Clin Chim Acta. 2016 Jan 30;453:1-12. doi: 10.1016/j.cca.2015.11.029. Epub 2015 Dec 2.
Liu WC1, Wu CC2, Hung YM3, Liao MT4, Shyu JF5, Lin YF6, Lu KC7, Yeh KC8.


Abstract fails to mention the many ways to reduce vascular calcification
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Items in both Kidney and Calcitriol categories in VitaminDWiki:

Low 25(OH)D levels are common in chronic kidney disease (CKD) patients and are implicated in all-cause mortality and morbidity risks. Furthermore, the progression of CKD is accompanied by a gradual decline in 25(OH)D production. Vitamin D deficiency in CKD causes skeletal disorders, such as osteoblast or osteoclast cell defects, bone turnover imbalance, and deterioration of bone quality, and nonskeletal disorders, such as metabolic syndrome, hypertension, immune dysfunction, hyperlipidemia, diabetes, and anemia. Extra-renal organs possess the enzymatic machinery for converting 25(OH)D to 1,25(OH)2D, which may play considerable biological roles beyond the traditional roles of vitamin D.

Pharmacological 1,25(OH)2D dose causes hypercalcemia and hyperphosphatemia as well as adynamic bone disorder, which intensifies vascular calcification. Conversely, native vitamin D supplementation reduces the risk of hypercalcemia and hyperphosphatemia, which may play a role in managing bone and cardio-renal health and ultimately reducing mortality in CKD patients. Nevertheless, the combination of native vitamin D and active vitamin D can enhance therapy benefits of secondary hyperparathyroidism because of extra-renal 1a-hydroxylase activity in parathyroid gland. This article emphasizes the role of native vitamin D replacements in CKD, reviews vitamin D biology, and summarizes the present literature regarding native vitamin D replacement in the CKD population.

PMID: 26656443 DOI: 10.1016/j.cca.2015.11.029