Role of vitamin D receptor activators in peritoneal dialysis.
Chronic kidney disease (CKD), including patients on peritoneal dialysis (PD), is linked to an important increase in mortality risk. Within the new systemic term CKD-MBD, alterations in vitamin D metabolism are also included. Many adverse events have been associated with vitamin D deficiency or lack of vitamin D receptor (VDR) activation both in the general population and CKD patients, and these associations seem to be maintained in PD patients. Particularities of PD in vitamin D metabolism, calcium balance, low PTH levels and the high prevalence of adynamic bone disease are discussed. We also review the associations of clinical or survival benefits with vitamin D supplementation, VDR or selective VDR activation, although they are low-graded and most of them obtained from HD databases. Nevertheless, we think that the combined approach to secondary hyperparathyroidism seems also to be appropriate in PD patients, and vitamin D (native plus VDR or selective VDR activation) seem an important part of the required integral approach. The later may provide additional benefits but definitive prove is still lacking.
J
J
Bover
M J
MJ
Lloret
I
I
DaSilva
M
M
Furlano
M
M
Díaz
A
A
Herreros
M
M
Cozzolino
J
J
Ballarín
D019587:Dietary Supplements; D006801:Humans; D010281:Parathyroid Hormone / Q000097:blood; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000401:mortality; D018167:Receptors, Calcitriol / Q000502:physiology*; D014807:Vitamin D / Q000008:administration & dosage / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000378:metabolism
D010281:Parathyroid Hormone; D018167:Receptors, Calcitriol; D014807:Vitamin D