title: The uses and abuses of Vitamin D compounds in chronic kidney disease-mineral bone disease (CKD-MBD).
abstract: Vitamin D is of paramount importance to skeletal development, integrity and health. Vitamin D homeostatis is typically deranged in a number of chronic conditions, of which chronic kidney disease is one of the most important. The use of vitamin D based therapy to target secondary hyperparathyroidism is now several decades old, and there is a large body of clinical practice, experience, guidelines and research to underpin this. However, there are many unknowns, of significant clinical relevance. Amongst which is what "species" of vitamin D we should be using, in what patient, and, under what conditions. Sadly, there has been a real dearth of randomised controlled trials, and trials with outputs of clinical relevance, which means our clinical practice has not developed and refined adequately ove the last 4 decades. This article will discuss the vexed but critical questions of which vitamin D therapies might suit which kidney patients, and will high-light the many important clinical questions which urgently require answering.
authors.affiliation: Renal and Transplantation Department, Guy׳s and St Thomas׳ Hospitals, London, United Kingdom. Electronic address: david.goldsmith@gstt.nhs.uk.
authors.forename: D J A
authors.initials: DJ
authors.lastname: Goldsmith
authors.affiliation: Division of Nephrology, Ambroise Paré Hospital, Paris Ile de France Ouest University, Paris, France; INSERM U1088, Amiens, France.
authors.forename: Z A
authors.initials: ZA
authors.lastname: Massy
authors.affiliation: Department of Cardiology and Intensive Care Medicine, RWTH University Hospital Aachen, Aachen, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Brandenburg
mesh_terms: D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D019587:Dietary Supplements; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D007273:Injections, Intramuscular; D018167:Receptors, Calcitriol / Q000819:agonists; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D014467:Ultraviolet Therapy; D014807:Vitamin D / Q000031:analogs & derivatives / Q000378:metabolism* / Q000627:therapeutic use*
chemical_list: D018167:Receptors, Calcitriol; D014807:Vitamin D
keywords: LVH; Vitamin D; hypercalcemia; hyperparathyroidism