title: Vitamin D Status in Chronic Kidney Disease - UVB Irradiation Is Superior to Oral Supplementation.
abstract: BACKGROUND
  In chronic kidney disease (CKD) a deficiency of 1,25-dihydroxyvitamin D is common. The aim of this review was to compare vitamin D status after oral supplementation of vitamin D3 to that of serial suberythemal irradiation in end-stage kidney disease (ESKD) patients.
  
  
  METHODS
  Ninety-five patients, with a mean age of 62 (range=35-82) years, were treated with a mean dose of 35,000 (20,000-60,000) IU vitamin D3 per week for a period of 18 months. Fourteen patients, with a mean age of 51 (range=41-57) years, were whole-body UVB irradiated for over 6 months. From 3 hemodialysis patients skin biopsies were performed.
  
  
  RESULTS
  With oral supplementation 25(OH)D3 increased by 60%. With UV irradiation 25(OH)D3 increased by 400%. Gene expression analysis demonstrated an improvement in the vitamin D receptor (VDR) by 0.65 fold, in 1-alpha-hydroxylase (CYP27B1) by 1.0 fold, and in 25-hydroxylase (CYP2R) by 1.2 fold.
  
  
  CONCLUSIONS
  Serial suberythemal UVB irradiation of patients with CKD on dialysis is capable to improve serum 25(OH)D3 and 1,25(OH)2D3 by enhancing the skin's ability to activate vitamin D.
authors.affiliation: Department of Natural Medicine, Research Group of Medical Heliotherapy, Charité - University Medicine Berlin and Immanuel Hospital, Berlin, Germany Nephrological Center Moabit, Curatorium for Dialysis and Kidney Transplantation, Berlin, Germany rolfdieter.krause@t-online.de.
authors.forename: Rolfdieter
authors.initials: R
authors.lastname: Krause
authors.affiliation: Department of Endocrinology, Limbach Laboratory, Heidelberg, Germany.
authors.forename: Heinz Jürgen
authors.initials: HJ
authors.lastname: Roth
authors.affiliation: Institute of Lighting Technics, Technical University Berlin, Berlin, Germany.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Kaase
authors.affiliation: Department of Natural Medicine, Research Group of Medical Heliotherapy, Charité - University Medicine Berlin and Immanuel Hospital, Berlin, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Stange
authors.affiliation: Department of Endocrinology, Vitamin D Research Laboratory, School of Medicine Boston University, Boston, MA, U.S.A.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Holick
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002112:Calcifediol / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism; D002117:Calcitriol / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism; D002762:Cholecalciferol / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism; D019587:Dietary Supplements; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018167:Receptors, Calcitriol / Q000378:metabolism; D006435:Renal Dialysis / Q000379:methods; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000378:metabolism*; D014466:Ultraviolet Rays; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood* / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D065668:Vitamin D3 24-Hydroxylase / Q000378:metabolism
chemical_list: D018167:Receptors, Calcitriol; D014807:Vitamin D; D002762:Cholecalciferol; C097949:1,25-dihydroxyvitamin D; D065668:Vitamin D3 24-Hydroxylase; D002117:Calcitriol; D002112:Calcifediol
keywords: 1,25-dihydroxyvitamin D; 1-alpha-hydroxylase; 25-hydroxyvitamin D; UVB irradiation; Vitamin D; chronic kidney disease (CKD); dialysis (ESKD); extra-renal synthesis; oral supplementation; vitamin D receptor