Chronic Kidney Disease needs Vitamin D: how much, what kind - many studies

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Vitamin D therapy in chronic kidney disease: a critical appraisal of clinical trial evidence - Aug 2024

Clinical Kidney Journal, Volume 17, Issue 8, August 2024, sfae227, https://doi.org/10.1093/ckj/sfae227
Wing-Chi G Yeung, Nigel D Toussaint, Sunil V Badve

Table of Contents

In people with chronic kidney disease (CKD), the physiology of vitamin D is altered and leads to abnormalities in bone and mineral metabolism which contribute to CKD mineral and bone disorder (CKD-MBD). Observational studies show an association between vitamin D deficiency and increased risk of mortality, cardiovascular disease and fracture in CKD. Although vitamin D therapy is widely prescribed in people with CKD, clinical trials to date have failed to demonstrate a clear benefit of either nutritional vitamin D supplementation or active vitamin D therapy in improving clinical outcomes in CKD. This review provides an updated critical analysis of recent trial evidence on vitamin D therapy in people with CKD.
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Vitamin D and Chronic Kidney Disease Association with Mineral and Bone Disorder: An Appraisal of Tangled Guidelines

Nutrients 2023, 15(7), 1576; https://doi.org/10.3390/nu15071576
by Jordi Bover 1,2,*ORCID,Elisabet Massó 1,2ORCID,Laia Gifre 3,Carlo Alfieri 4,5ORCID,Jordi Soler-Majoral 1,2,Maria Fusaro 6,7ORCID,Jordi Calabia 8ORCID,Rosely Rodríguez-Pena 1,2ORCID,Néstor Rodríguez-Chitiva 1,2ORCID,Víctor López-Báez 1,2ORCID,Maya Sánchez-Baya 1,2,Iara da Silva 1,2,Armando Aguilar 9,Misael C. Bustos 10,Natacha Rodrigues 11,Jonathan S. Chávez-Iñiguez 12,13ORCID,Gregorio Romero-González 1,2,José Manuel Valdivielso 14ORCID,Pablo Molina 15ORCID andJosé L. Górriz 16

Chronic kidney disease (CKD) is a highly prevalent condition worldwide in which the kidneys lose many abilities, such as the regulation of vitamin D (VD) metabolism. Moreover, people with CKD are at a higher risk of multifactorial VD deficiency, which has been extensively associated with poor outcomes, including bone disease, cardiovascular disease, and higher mortality. Evidence is abundant in terms of the association of negative outcomes with low levels of VD, but recent studies have lowered previous high expectations regarding the beneficial effects of VD supplementation in the general population. Although controversies still exist, the diagnosis and treatment of VD have not been excluded from nephrology guidelines, and much data still supports VD supplementation in CKD patients. In this narrative review, we briefly summarize evolving controversies and useful clinical approaches, underscoring that the adverse effects of VD derivatives must be balanced against the need for effective prevention of progressive and severe secondary hyperparathyroidism. Guidelines vary, but there seems to be general agreement that VD deficiency should be avoided in CKD patients, and it is likely that one should not wait until severe SHPT is present before cautiously starting VD derivatives. Furthermore, it is emphasized that the goal should not be the complete normalization of parathyroid hormone (PTH) levels. New developments may help us to better define optimal VD and PTH at different CKD stages, but large trials are still needed to confirm that VD and precise control of these and other CKD-MBD biomarkers are unequivocally related to improved hard outcomes in this population,
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CKD not helped by small doses of standard Vitamin D - Aug 2023

Vitamin D supplementation in people with CKD
Kidney Int . 2023 Aug 2;S0085-2538(23)00540-9. doi: 10.1016/j.kint.2023.07.010
Marc G Vervloet 1, Simon Hsu 2, Ian H de Boer 2

Vitamin D supplements have long been advocated for people with chronic kidney disease (CKD) based on data from observational studies among the general population and also people with CKD. These data consistently suggested that higher circulating concentrations of 25-hydroxyvitamin D are associated with improved fracture, cardiovascular, cancer, and mortality outcomes. In the last few years, large clinical trials have been conducted to assess the effects of vitamin D supplements on a range of clinically relevant outcomes. Most of these studies were performed in the general population but also enrolled people with CKD. Virtually all these trials were negative and contradicted the observational data. In this review, the key observational data and clinical trials are summarized and potential explanations for the discrepancies between these studies are discussed.
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How Much Vitamin D does CKD need: 50 ng, 80 ng?

• Need at least 80 ng of vitamin D if have chronic kidney disease – May 2012
• More than 30 ng of vitamin D is sometimes needed (Kidney needs 50 ng) – March 2019
• See also: Is 50 ng of vitamin D too high, just right, or not enough

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63+ VitaminDWiki pages with CHRONIC KIDNEY in title

This list is automatically updated

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Kidney category contains

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Overview Kidney and vitamin D contains

• FACT: The Kidneys are not the primary way to activate vitamin D; the tissues are
• 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 ongoing 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: 38% of seniors have Chronic Kidney Disease and most are unaware of it CDC statistics 2020
• 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,
  Nanoemulstion vitamin D (inside cheek, topically) gets activated Vitamin D to the cells without the need for healthy kidney, liver, or intestine
  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 232 items

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16 Items in both Kidney and Calcitriol categories (some believe that is the right form)

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