Chronic Kidney Disease clinical trials of UV in Germany – April 2013

Vitamin D and UV exposure in chronic kidney disease

Rolfdieter Krause
Dermato-Endocrinology Vol 5 #1

With loss of renal function and decreasing glomerula filtration rate the serum levels of 25-hydroxyvitamin D [25(OH)D] as well as 1,25-dihydroxyvitamin D [1,25 (OH)2 D] often decrease simultaneously. In representative groups of German patients on renal replacement therapy (hemodialysis, peritoneal dialysis, kidney transplantation) our group retrospectively analyzed the vitamin D status over a period of 12 y (1995‒2006).
Only 11% of patients had a serum level of 25(OH)D that was > 30 ng/ml, more than 70% had a level of 25(OH)D < 20 ng/ml.

In clinical trials we used sun-simulating artificial lamps to produce vitamin D3 in the skin.
Partial-body irradiation (15% of body surface) was used during the routine hemodialysis treatment.

Whole-body UV exposure was done in a standing position three times a week before the hemodialysis treatment. With both procedures we observed an increase of the serum level of 25(OH)2D3 by approx. 35–50% over a period of 2‒3 mo, maintenance of trabecular bone mineral density and a normalization of systolic and diastolic blood pressure.

Heart rate variability improved during the whole-body radiation intervention period by 20‒25%. Patients who continued the whole-body irradiation regularly two or three times before starting the routine hemodialysis session had maintained normal levels of circulating 25(OH)D3 and of 1,25(OH)2D3. Therefore, from our data it can be recommended that intermittent suberythemal UVB exposure with a sun-simulation spectrum is effective to treat and/or protect against vitamin D deficiency in chronic and end-stage kidney disease patients.

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See also Vitamin D Life

• Kidney patients need some form vitamin D – the question is, which form – July 2013
• Dialysis patients need real vitamin D – Editorial July 2013
• Those Dialysis patients with low vitamin D were 75% more likely to die – July 2013
• Chronic kidney with low vitamin D: 90 percent of pediatric nephrologists now recommend more D – Feb 2013
• Vitamin D reduced risk of death of Chronic Kidney Disease by 30 percent: Meta-analysis March 2013
• Vitamin D level can be high, but little benefit: due to kidney, genes, low Magnesium etc.
• Kidney disease requires magnesium - Jan 2013
• Overview Kidney and vitamin D contains the following summary
  *FACT: Kidney is the primary way to activate vitamin D
• 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 on-going 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: 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,
  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 193 items

See also web

• Vitamin D supplementation in pre-dialysis chronic kidney disease:
  A systematic review, 1 Jun 2012 — Dermato-Endocrinology