Which Vitamin D in CKD-MBD? The Time of Burning Questions
BioMed Research International, Volume 2013 (2013), Article ID 864012, 10 pages
1 Antonio Bellasi,2,3 Sara Auricchio,1 Sergio Papagni,4 and Mario Cozzolino31Medical Department, Nephrology Unit, AO Desio Vimercate, Desio Hospital, 20832 Desio, Italy
2 Department of Nephrology, Sant’Anna Hospital, 22020 Como, Italy
3 Department of Health Sciences, University of Milan, 20142 Milan, Italy
4 Division of Nephrology, Dialysis Center CBH-Città di Bisceglie, 70052 Bisceglie, Italy
Vitamin D is a common treatment against secondary hyperparathyroidism in renal patients. However, the rationale for the prescription of vitamin D sterols in chronic kidney disease (CKD) is rapidly increasing due to the coexistence of growing expectancies close to unsatisfactory evidences, such as
- the lack of randomized controlled trials (RCTs) proving the superiority of any vitamin D sterol against placebo on patients centered outcomes,
- the scanty clinical data on head to head comparisons between the multiple vitamin D sterols currently available,
- the absence of RCTs confirming the crescent expectations on nutritional vitamin D pleiotropic effects even in CKD patients,
- the promising effects of vitamin D receptors activators (VDRA) against proteinuria and myocardial hypertrophy in diabetic CKD cohorts, and
- the conflicting data on the impact on mortality of VDRA versus calcimimetic centered regimens to control CKD-MBD.
The present review arguments these issues focusing on the opened questions that nephrologists should consider dealing with the prescription of nutritional vitamin D or VDRA and with the choice of a VDRA versus a calcimimetic based regimen in CKD-MBD patients.
CKD-MBD =Chronic Kidney Disease - Mineral and Bone Disorders
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See also VitaminDWiki
- Overview Kidney and vitamin D
- Dialysis patients need real vitamin D – Editorial July 2013
- Chronic kidney with low vitamin D: 90 percent of pediatric nephrologists now recommend more D – Feb 2013
- Comparing Vitamin D and analogs for kidney patients – May 2013
- Standard and artificial vitamin D both help Chronic Kidney Disease – meta-analysis April 2013
- Most Chronic Kidney Disease patients restored their vitamin D levels with just 1,000 IU – Dec 2013