Kidney patients need some form vitamin D – the question is, which form – July 2013

Which Vitamin D in CKD-MBD? The Time of Burning Questions

BioMed Research International, Volume 2013 (2013), Article ID 864012, 10 pages
1 Antonio Bellasi,2,3 Sara Auricchio,1 Sergio Papagni,4 and Mario Cozzolino31Medical Department, Nephrology Unit, AO Desio Vimercate, Desio Hospital, 20832 Desio, Italy
2 Department of Nephrology, Sant’Anna Hospital, 22020 Como, Italy
3 Department of Health Sciences, University of Milan, 20142 Milan, Italy
4 Division of Nephrology, Dialysis Center CBH-Città di Bisceglie, 70052 Bisceglie, Italy

Vitamin D is a common treatment against secondary hyperparathyroidism in renal patients. However, the rationale for the prescription of vitamin D sterols in chronic kidney disease (CKD) is rapidly increasing due to the coexistence of growing expectancies close to unsatisfactory evidences, such as

1. the lack of randomized controlled trials (RCTs) proving the superiority of any vitamin D sterol against placebo on patients centered outcomes,
2. the scanty clinical data on head to head comparisons between the multiple vitamin D sterols currently available,
3. the absence of RCTs confirming the crescent expectations on nutritional vitamin D pleiotropic effects even in CKD patients,
4. the promising effects of vitamin D receptors activators (VDRA) against proteinuria and myocardial hypertrophy in diabetic CKD cohorts, and
5. the conflicting data on the impact on mortality of VDRA versus calcimimetic centered regimens to control CKD-MBD.

The present review arguments these issues focusing on the opened questions that nephrologists should consider dealing with the prescription of nutritional vitamin D or VDRA and with the choice of a VDRA versus a calcimimetic based regimen in CKD-MBD patients.

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CKD-MBD =Chronic Kidney Disease - Mineral and Bone Disorders
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See also Vitamin D Life

• Overview Kidney and vitamin D
• Dialysis patients need real vitamin D – Editorial July 2013
• Chronic kidney with low vitamin D: 90 percent of pediatric nephrologists now recommend more D – Feb 2013
• Comparing Vitamin D and analogs for kidney patients – May 2013
• Standard and artificial vitamin D both help Chronic Kidney Disease – meta-analysis April 2013
• Most Chronic Kidney Disease patients restored their vitamin D levels with just 1,000 IU – Dec 2013