title: Vitamin D3 repletion in chronic kidney disease stage 3: effects on blood endotoxin activity, inflammatory cytokines, and intestinal permeability.
abstract: BACKGROUND
  Vitamin D deficiency is common in the general population and even more prevalent in patients with chronic kidney disease (CKD). Low 25-hydroxyvitamin D [25(OH)D] levels have been associated with cardiovascular disease, though a definitive mechanistic link has not been established. Further, it is unclear if repleting vitamin D mitigates the excess risk observed in epidemiologic studies. Because vitamin D may regulate innate immunity and gut epithelial differentiation, we hypothesized that oral cholecalciferol (D3) would result in decreased blood endotoxin activity, a potential risk factor for cardiovascular disease. STUDY DESIGN, SETTING & PARTICIPANTS, INTERVENTION: We studied 12 stable outpatients with CKD stage 3 and 25(OH)D deficiency, who received D3 30,000 units weekly for 8 weeks. The primary endpoint was the change in blood endotoxin activity.
  
  
  RESULTS
  Baseline endotoxin activity correlated with 25(OH)D levels (r = -0.60, p = 0.04). Endotoxin activity decreased by 25% from baseline (p = 0.03). Despite the decrease in endotoxin activity, there was no change in intestinal permeability.
  
  
  CONCLUSIONS
  The results of this study suggest that vitamin D repletion therapy may have an effect on endotoxin activity in early CKD. Further intervention studies using vitamin D in the CKD population are required.
authors.affiliation: Laboratory of Biochemical Genetics and Metabolism, Rockefeller University, New York, NY 10065, USA. mponda@rockefeller.edu
authors.forename: Manish P
authors.initials: MP
authors.lastname: Ponda
authors.forename: Jan L
authors.initials: JL
authors.lastname: Breslow
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002762:Cholecalciferol / Q000008:administration & dosage*; D016207:Cytokines / Q000097:blood*; D004731:Endotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007413:Intestinal Mucosa / Q000378:metabolism*; D007422:Intestines / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010539:Permeability; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood*
chemical_list: D015415:Biomarkers; D016207:Cytokines; D004731:Endotoxins; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D