Standard and artificial vitamin D both help Chronic Kidney Disease – meta-analysis April 2013

Impact of Vitamin D on Chronic Kidney Diseases in Non-Dialysis Patients:
A Meta-Analysis of Randomized Controlled Trials

PLoS ONE 8(4): e61387. doi:10.1371/journal.pone.0061387
Lijuan Xu, Xuesi Wan, Zhimin Huang, Fangfang Zeng, Guohong Wei, Donghong Fang, Wanping Deng, Yanbing Li mail

Background and Objectives: Recent studies have supported a role for both newer and more established vitamin D compounds in improving proteinuria, although systematic evaluation is lacking. Furthermore, concerns remain regarding the influence of vitamin D on the progression of renal function. We analyzed the efficacy and safety of vitamin D in non-dialysis patients and compared the use of newer versus established vitamin D compounds by performing a meta-analysis of randomized controlled trials.

Design: A literature search of PubMed (1975 to September, 2012), EMBASE.com (1966 to September, 2012) and Ovid EBM Reviews (through September, 2012) was conducted.

Results: Eighteen studies were eligible for final inclusion; of these, six explored the effects of vitamin D on proteinuria, twelve studied the effects of supplementation on renal function, and fifteen discussed the incidence of hypercalcemia. Compared to the placebo or no interference, both the newer and established vitamin D sterols reduced proteinuria to a similar extent (RR, 2.00; 95% CI, 1.42 to 2.81). No decrease in the glomerular filter rate was observed (SMD, −0.10; 95%CI, −0.24 to 0.03), and the risk for dialysis initiation was 1.48 (95% CI, 0.54 to 4.03) with vitamin D treatment. Additionally, there was an increased risk of hypercalcemia for patients treated with either newer or established vitamin D compounds as compared with the controls (RR, 4.78; 95% CI, 2.20 to 10.37). The head-to-head studies showed no differences in the effects of either newer or established compounds on proteinuria or the risk of hypercalcemia. No serious adverse events were associated with the administration of vitamin D.

Conclusions: Vitamin D therapy appears to decrease proteinuria and have no negative influence on renal function in non-dialysis patients.
But the occurrence of hypercalcemia should be evaluated when vitamin D is provided.
No superiority for newer versus established vitamin D analogue is found.

Received: November 5, 2012; Accepted: March 8, 2013; Published: April 23, 2013

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See also Vitamin D Life

• Overview Kidney and vitamin D
• All items in category Kidney and Vitamin D 193 items
• Active vitamin D treats Chronic Kidney Disease by stimulating Klotho production – Dec 2012
• Kidney Dialysis clinics reluctant to add vitamin D treatment as they are not reimbursed – Oct 2012
• With CKD should measure the active form of vitamin D – April 2012
• Omega 3 increased by 60 percent the ACTIVE vitamin D in the blood – Aug 2012 consider adding Omega-3 when when Kidney is not operating properly
• Chronic Kidney Disease and Vitamin D Analogs – commentary Jan 2013 which has the following chart