Vascular function and cholecalciferol supplementation in CKD: A self-controlled case series
The Journal of Steroid Biochemistry and Molecular Biology, online5 January 2018, https://doi.org/10.1016/j.jsbmb.2018.01.001
Vivek Kumara, , , Ashok Kumar Yadava, Manphool Singhalb, Vinod Kumara, Anupam Lalb, Debasish Banerjeec, d, Krishan Lal Guptaa, Vivekanand Jhaa, e, f
Vitamin D given to 31 individuals having CKD– not a randomized controlled trial
cause of CKD was unknown in 50% of subjects.
Around 94% were hypertensive
| Week 1 | measurement, 300,000 IU dose |
| Week 8 | 300,000 IU dose |
| Week 16 | measurement |
All of the following measurements had significant increases
1,25(OH)2D 1,25-Dihydroxyvitamin D
25(OH)D 25-Hydroxyvitamin D
FMD Endothelium dependent flow mediated dilatation
iFGF-23 Intact fibroblast growth factor-23
IL-6 Interleukin-6
iPTH Intact parathormone
NMD Endothelium independent nitroglycerine mediated dilatation
PWV Pulse wave velocity
See also Vitamin D Life
- Chronic Kidney Disease mortality is 60 percent less likely if good vitamin D – meta-analysis July 2017
- Standard oral vitamin D is not a good way to supplement if have Chronic Kidney Disease – March 2016
- Injection category listing has 53 items along with related searches
Overview Loading of vitamin D contains the following
Loading dose: 153 studies at Vitamin D LifeVitamin D loading dose (stoss) proven to improve health overview
If a person is or is suspected to be, very vitamin D deficient a loading dose is typically given
- Loading = restore = quick replacement by 1 or more doses
- Loading doses range in total size from 100,000 IU to 1,000,000 IU of Vitamin D3
- = 2.5 to 25 milligrams
- The size of the loading dose is a function of body weight - see below
- Unfortunately, some doctors persist in using Vitamin D2 instead of D3
- Loading may be done as quickly as a single day (Stoss), to as slowly as 3 months.
- It appears that spreading the loading dose over 4+ days is slightly better if speed is not essential
- Loading is typically oral, but can be Injection (I.M,) and Topical
- Loading dose is ~3X faster if done topically or swished inside of the mouth
- Skips the slow process of stomach and intestine, and might even skip liver and Kidney as well
- The loading dose persists in the body for 1 - 3 months
- The loading dose should be followed up with on-going maintenance dosing
- Unfortunately, many doctors fail to follow-up with the maintenance dosing.
- About 1 in 300 people have some form of a mild allergic reaction to vitamin D supplements, including loading doses
- it appears prudent to test with a small amount of vitamin D before giving a loading dose
- The causes of a mild allergic reaction appear to be: (in order of occurrence)
- 1) lack of magnesium - which can be easily added
- 2) allergy to capsule contents - oil, additives (powder does not appear to cause any reaction)
- 3) allergy to the tiny amount of D3 itself (allergy to wool) ( alternate: D3 made from plants )
- 4) allergy of the gut to Vitamin D - alternative = topical
Kidney category starts with
Kidney category listing has 193 itemssee also Overview Kidney and vitamin D
Search Vitamin D Life for dialysis OR haemodialysis 878 items not in PDF as of Aug 2020
Search Vitamin D Life for kidney transplant 798 items as of June 2019
"Chronic Kidney Disease" OR CKD 874 items as of Jan 2018
Kidney Intervention trials using Vitamin D:
- Chronic Kidney Disease (stage 3) slowed by 30 ng of Vitamin D and Calcitriol – Dec 2019
- Diabetic nephropathy (Kidney) treated by 50,000 IU of vitamin D weekly – RCT Jan 2019
- Hemodialysis patients (CKD) helped by weekly 50,000 IU of vitamin D – Jan 2017
- Kidney disease helped by active or high dose Vitamin D - Feb 2014
- Peritoneal Dialysis nicely treated by active vitamin D – July 2013
- 7100 IU (50000 weekly) restored vitamin D levels for those with Chronic Kidney Disease – July 2012
- Chronic Kidney Disease reduced with 3600 IU vitamin D (50000 twice a month)– RCT Aug 2012
- Overview Kidney and vitamin D
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
The items in both Kidney and Loading Dose categories in Vitamin D Life are:
Download the PDF from Vitamin D Life
Highlights
- Cholecalciferol supplementation in patients with CKD and vitamin D deficiency improved endothelial function (FMD) and vascular stiffness (PWV).
- NMD also improved which is a novel finding and needs to be explored further.
- PTH decreased with cholecalciferol supplementation.
- FGF-23 also decreased with cholecalciferol supplementation unlike previously reported increase with use of activated vitamin D.
Vitamin D deficiency is common and associated with mortality in chronic kidney disease (CKD) patients. Cardiovascular disease (CVD) is the commonest cause of mortality in CKD patients. In a randomized, double blind, placebo controlled trial, we have recently reported favorable effects of vitamin D supplementation on vascular & endothelial function and inflammatory biomarkers in vitamin D deficient patients with non-diabetic stage 3-4 CKD (J Am Soc Nephrol 28: 3100–3108, 2017). Subjects in the placebo group who had still not received vitamin D after completion of the trial received two oral doses 300000 IU of oral cholecalciferol at 8 weeks interval followed by flow mediated dilatation (FMD), pulse wave velocity (PWV), circulating endothelial and inflammatory markers (E-Selectin, vWF, hsCRP and IL-6), 1,25 (OH)2D, iPTH and iFGF-23 assessment at 16 weeks. 31 subjects completed this phase of the study. Last values recorded in the preceding clinical trial were taken as baseline values. Serum 25(OH)D and 1,25(OH)2D increased and FMD significantly improved after cholecalciferol supplementation [mean change in FMD%: 5.8% (95% CI: 4.0-7.5%, p<0.001]. Endothelium independent nitroglycerine mediated dilatation, PWV, iPTH, iFGF-23 and IL-6 also showed favorable changes. The data further cement the findings of beneficial effects of correction of vitamin D deficiency on vascular function.