title: Vitamin D supplementation in renal disease: is calcitriol all that is needed?
abstract: Vitamin D not only plays important roles in mineral metabolism, but also affects the risk of mortality and cardiovascular events. Since the kidney is the main organ that produces 1,25-dihydroxyvitamin D, active vitamin D sterols are widely used in patients with chronic kidney disease (CKD), especially those with secondary hyperparathyroidism. CKD patients also have higher risk of vitamin D deficiency, due to urinary loss associated with proteinuria and possible down-regulation of megalin in the proximal tubular cells. Accordingly, it is reasonable to supplement nutritional vitamin D in CKD patients with vitamin D deficiency. Although still unclear, it has been suggested that local 1α-hydroxylase activity plays more significant roles in CKD patients compared to those with normal kidney function. Future studies should examine whether correction of vitamin D deficiency, administration of active vitamin D, or both, provides survival benefits in patients with CKD.
authors.affiliation: Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan. fukagawa@tokai-u.jp
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukagawa
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Komaba
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hamano
mesh_terms: D002117:Calcitriol / Q000627:therapeutic use*; D002908:Chronic Disease; D019587:Dietary Supplements; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism*; D014807:Vitamin D / Q000008:administration & dosage* / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000209:etiology
chemical_list: D014807:Vitamin D; D002117:Calcitriol