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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

Loading dose: 207 studies at VitaminDWiki

Vitamin D loading dose (stoss therapy) proven to improve health overview
If a person is or is suspected to be, very vitamin D deficient a loading dose should be given

  • Loading = restore = quick replacement by 1 or more doses
  • Loading doses range in total size from 100,000 IU to 1,000,000 IU of Vitamin D3
    • = 2.5 to 25 milligrams
  • 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 (Stoss), to as slowly as 3 months.
    • It appears that spreading the loading dose over 4+ days is slightly better if speed is not essential
  • Loading is typically oral, but can be Injection (I.M,) and Topical
  • Loading dose is ~3X faster if done topically or swished inside of the mouth
    • Skips the slow process of stomach and intestine, and might even skip liver and Kidney as well
  • The loading dose persists in the body for 1 - 3 months
    • The loading dose should be followed up with on-going maintenance dosing
    • Unfortunately, many doctors fail to follow-up with the maintenance dosing.
  • About 1 in 300 people have some form of a mild allergic reaction to vitamin D supplements, including loading doses
    • 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 occurrence)
    • 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 )
    • 4) allergy of the gut to Vitamin D - alternative = topical

Kidney category starts with

Overview Kidney and vitamin D contains the following summary


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 GMT-0000 by admin. (Version 10)

Attached files

ID Name Comment Uploaded Size Downloads
9255 Vascular function and cholecalciferol supplementation in CKD.pdf admin 25 Jan, 2018 153.14 Kb 758
9139 300,000.jpg admin 06 Jan, 2018 145.98 Kb 1173