The Vitamin D System: A Crosstalk Between the Heart and Kidney
Mario Cozzolino; Markus Ketteler; Daniel Zehnder
Eur J Heart Fail. 2010 Oct;12(10):1031-41.
Chronic kidney disease (CKD) independently increases the rates of cardiovascular disease, whereas the severity of kidney disease correlates with increased cardiovascular morbidity and death. Vitamin D is modified in the liver and the kidney to its active form (1,25-dihydroxyvitamin D) by the 25-hydroxy vitamin D 1-hydroxylase enzyme (CYP27B1). The activated vitamin D brings about its actions through the vitamin D receptor (VDR). The VDRs and CYP27B1 have recently been shown to be expressed in several tissues, not directly involved in mineral homeostasis, including the cardiovascular, immune, and epithelial systems. The action of vitamin D in these tissues is implicated in the regulation of endothelial, vascular smooth muscle, and cardiac cell function, the renin–angiotensin system, inflammatory and fibrotic pathways, and immune response. Impaired VDR activation and signalling results in cellular dysfunction in several organs and biological systems, which leads to reduced bone health, an increased risk for epithelial cancers, metabolic disease, and uncontrolled inflammatory responses. Failure of cardiovascular VDR activation results in hypertension, accelerated atherosclerosis and vascular calcification, cardiac hypertrophy with vascular rarification and fibrosis, and progressive renal dysfunction. An emerging body of evidence has prompted attention to the relationship between CKD, mineral bone disorder (CKD-MBD), and cardiovascular disease in the new guidelines from Kidney Disease: Improving Global Outcomes. Vitamin D receptor activators, commonly used to treat CKD-MBD, and an appropriate treatment of vitamin D hormonal system failure in patients with CKD, may help to reduce cardiovascular morbidity and mortality in these patients.
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It is amazing that such excellent results were buried in the paper. They were not in the title nor abstract.
This is the result of about 10 trials with about 5,000 kidney disease patients.
Note: some of the trials were terminated as they felt it morally wrong to not give vitamin D to all of the Kidney patients
Probable clue in the conflict of interest at the end of the paper
A 2010 book: White Coat, Black Hat describes the problem very well.
Overview Kidney and vitamin D contains the following summary
- 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
Kidney category starts with:Kidney category listing has
see also Overview Kidney and vitamin D
Peritoneal dialysis in titles in VitaminDWiki (3 titles as of Oct 2021)
CKD or CHRONIC KIDNEY DISEASE in title of 65 pages as of Dec 2022
- Kidney Inflammation not reduced by 30 ng Vitamin D (many health problems need 50 ng) – Nov 2022
- Chronic Kidney Disease decreases Vitamin D in 4 ways – Nov 2017
- Half as much chronic kidney disease infection if supplement with Vitamin D – 2018
- 2.4 times more likely to die if have Chronic Kidney Disease and low vitamin D - Sept 2016
- 4X more Chronic Kidney disease patients are now using vitamin D – March 2014
- Poor kidneys rarely get enough or the right form of vitamin D – Feb 2019
56 items along with related searchesAdding Vitamin D decreased kidney deaths by 4x – Dec 2010 7896 visitors, last modified 06 Feb, 2021,This page is in the following categories (# of items in each category)
ID Name Comment Uploaded Size Downloads 329 kidney conflict.gif admin 03 Dec, 2010 02:18 9.47 Kb 1595 328 Kidney mortality with vitamin D intervention.gif admin 03 Dec, 2010 02:09 17.93 Kb 1848