The role of vitamin D in mild to moderate chronic kidney disease.
Dietary vitamin D is a prohormone that is metabolized to the bioactive vitamin D hormone, 1 alpha, 25-dihydroxyvitamin D [1,25-(OH)2D]. 1,25-(OH)2D has been implicated in a variety of regulatory pathways that extend well beyond its traditional function in Ca2+ homeostasis. In uncovering these diverse functions, investigators have focused on the complex interaction between 1,25-(OH)2D and parathyroid hormone (PTH). Here, we present an overview of the functions of vitamin D hormone and PTH in the clinical context of secondary hyperparathyroidism. We discuss recent developments in treatment that address imbalances in vitamin D hormone and PTH levels, supporting the argument that early intervention can reduce the risk of metabolic complications caused by vitamin D hormone deficiency in patients with chronic kidney disease.
Friedman
Theodore C
TC
Dept Internal Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA 90059, USA.
Norris
Keith C
KC
D000818:Animals; D002118:Calcium / Q000378:metabolism; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000378:metabolism / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D010281:Parathyroid Hormone / Q000378:metabolism; D010710:Phosphates / Q000378:metabolism; D014807:Vitamin D / Q000031:analogs & derivatives / Q000378:metabolism / Q000502:physiology*; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*
D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D002118:Calcium