Chronic Kidney not helped much by little vitamin D (none got to a 75 nmol level) – meta-analysis Sept 2023

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Effect of regulated vitamin D increase on vascular markers in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials

Nutrition, Metabolism & Cardiovascular Diseases, https://doi.org/10.1016/j.numecd.2023.09.015

Aim
The effect of increased vitamin D levels on vascular function in patients with chronic kidney disease (CKD) is controversial. This meta-analysis aimed to assess the effect of regulated vitamin D increase on vascular markers in patients with CKD.

Data synthesis
We searched PubMed, Web of Science, Embase and ClinicalTrials.gov from database inception up until July 21, 2023. We included randomized controlled trials assessing the effects of using vitamin D and its analogues on vascular function in patients with CKD. Fixed-effects and random-effects model analyses were performed using weighted mean difference effects for each trial by heterogeneity (I2) assessment. Primary outcomes encompassed blood flow-mediated dilation (FMD)、pulse wave velocity (PWV) and augmentation index (AIx).

Findings
From 1964 records we selected 12 trials, 5 (n = 331) on FMD, 8 (n = 626) on PWV and 4 (n = 393) on AIx. Vitamin D and VDRA supplementation failed to significantly improve FMD (WMD 1.68%; 95% CI -0.18 to 3.53; P = 0.08; I2 = 88%)、PWV (WMD -0.41 m/s; 95%CI -0.95 to 0.13; P = 0.14; I2 = 57%)and AIx (WMD -0.53%; 95%CI -1.69 to 0.63; P = 0.37; I2 = 0%). Subgroup analysis revealed that 2 μg paricalcitol significantly improved FMD (WMD 2.09%; 95%CI 1.28 to 2.90; P < 0.00001); I2 = 0%), as did cholecalciferol (WMD 5.49%; 95% CI 4.35 to 6.63; P < 0.00001).

Conclusion
Supplementation vitamin D and VDRA are associated with improved vascular function as measured by FMD, but not arterial stiffness as measured by PWV and AIx, tentatively suggesting that regulating the increase of vitamin D could not potentially reduce the incidence of cardiovascular disease.

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Vitamin D Life – 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 225 items

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

Chronic Kidney Disease decreases Vitamin D level in 4 ways
4X more Chronic Kidney disease patients are now using vitamin D – March 2014
Vitamin D testers have different test results if there is chronic kidney disease – Sept 2019
Kidney dialysis often filters out vitamin D
Low vitamin D causes many health problems, such as weak bones
Want to have good Vitamin D levels to prevent CKD from causing other health problems
Higher vitamin D levels can treat CKD 50 ng   80 ng
Monthly dosing appears better than daily for CKD and many other health problems
CKD also decreases Vitamin K2-7
Form of vitamin D to be used; normal, Calcitriol, or synthetic
Non-oral form is often better for CKD ( topical, emulsion swished in mouth, patch cream, etc)