title: The effect of cholecalciferol for lowering albuminuria in chronic kidney disease: a prospective controlled study.
abstract: BACKGROUND
  Growing evidence indicates that vitamin D receptor activation may have antiproteinuric effects. We aimed to evaluate whether vitamin D supplementation with daily cholecalciferol could reduce albuminuria in proteinuric chronic kidney disease (CKD) patients.
  
  
  METHODS
  This 6-month prospective, controlled, intervention study enrolled 101 non-dialysis CKD patients with albuminuria. Patients with low 25(OH) vitamin D [25(OH)D] and high parathyroid hormone (PTH) levels (n = 50; 49%) received oral cholecalciferol (666 IU/day), whereas those without hyperparathyroidism (n = 51; 51%), independent of their vitamin D status, did not receive any cholecalciferol, and were considered as the control group.
  
  
  RESULTS
  Cholecalciferol administration led to a rise in mean 25(OH)D levels by 53.0 ± 41.6% (P < 0.001). Urinary albumin-to-creatinine ratio (uACR) decreased from (geometric mean with 95% confidence interval) 284 (189-425) to 167 mg/g (105-266) at 6 months (P < 0.001) in the cholecalciferol group, and there was no change in the control group. Reduction in a uACR was observed in the absence of significant changes in other factors, which could affect proteinuria, like weight, blood pressure (BP) levels or antihypertensive treatment. Six-month changes in 25(OH)D levels were significantly and inversely associated with that in the uACR (Pearson's R = -0.519; P = 0.036), after adjustment by age, sex, body mass index, BP, glomerular filtration rate and antiproteinuric treatment. The mean PTH decreased by -13.8 ± 20.3% (P = 0.039) only in treated patients, with a mild rise in phosphate and calcium-phosphate product [7.0 ± 14.7% (P = 0.002) and 7.2 ± 15.2% (P = 0.003), respectively].
  
  
  CONCLUSIONS
  In addition to improving hyperparathyroidism, vitamin D supplementation with daily cholecalciferol had a beneficial effect in decreasing albuminuria with potential effects on delaying the progression of CKD.
authors: Department of Nephrology, Hospital Universitario Dr Peset, Valencia, Spain.
authors: Pablo
authors: P
authors: Molina
authors: José L
authors: JL
authors: Górriz
authors: Mariola D
authors: MD
authors: Molina
authors: Ana
authors: A
authors: Peris
authors: Sandra
authors: S
authors: Beltrán
authors: Julia
authors: J
authors: Kanter
authors: Verónica
authors: V
authors: Escudero
authors: Ramón
authors: R
authors: Romero
authors: Luis M
authors: LM
authors: Pallardó
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000209:etiology / Q000517:prevention & control*; D002762:Cholecalciferol / Q000627:therapeutic use*; D019587:Dietary Supplements; D018450:Disease Progression; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000188:drug therapy; D014815:Vitamins / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol
keywords: albuminuria; chronic kidney disease; hyperparathyroidism; vitamin D