Vitamin D therapy in chronic kidney disease: back to the future?

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Abstract

Deficiency of 1,25(OH)2 vitamin D is inevitable in CKD, and is part of a cascade of bone and mineral abnormalities that result in secondary hyperparathyroidism. The widespread acceptance of calcitriol therapy as the treatment paradigm, has resulted in an overall neglect of vitamin D deficiency, as defined by low serum 25(OH)D levels Recent research has greatly enhanced our understanding of the disordered vitamin D metabolism seen in CKD. Furthermore vitamin D has been implicated in numerous disease states, beyond its traditional role in regulating bone and mineral metabolism. Low serum 25(OH)D levels have been linked to numerous adverse clinical outcomes in health and CKD. Additionally, the recognition of extra-renal, autocrine 1,25(OH)2D synthesis, present in many tissues, has refocused attention on the therapeutic potential of correcting low serum 25(OH)D levels. In this review we examine the physiology of disordered vitamin D metabolism in CKD, the clinical associations of low 25(OH)D levels in CKD, and discuss the rationale for vitamin D replacement in current clinical practice.
Original languageEnglish
Pages (from-to)65 - 74
Number of pages10
JournalClinical Nephrology
Volume84
Issue number2
DOIs
Publication statusPublished - 2015

Cite this

@article{59df44f1b91348ce8a75d3897512e8c0,
title = "Vitamin D therapy in chronic kidney disease: back to the future?",
abstract = "Deficiency of 1,25(OH)2 vitamin D is inevitable in CKD, and is part of a cascade of bone and mineral abnormalities that result in secondary hyperparathyroidism. The widespread acceptance of calcitriol therapy as the treatment paradigm, has resulted in an overall neglect of vitamin D deficiency, as defined by low serum 25(OH)D levels Recent research has greatly enhanced our understanding of the disordered vitamin D metabolism seen in CKD. Furthermore vitamin D has been implicated in numerous disease states, beyond its traditional role in regulating bone and mineral metabolism. Low serum 25(OH)D levels have been linked to numerous adverse clinical outcomes in health and CKD. Additionally, the recognition of extra-renal, autocrine 1,25(OH)2D synthesis, present in many tissues, has refocused attention on the therapeutic potential of correcting low serum 25(OH)D levels. In this review we examine the physiology of disordered vitamin D metabolism in CKD, the clinical associations of low 25(OH)D levels in CKD, and discuss the rationale for vitamin D replacement in current clinical practice.",
author = "Matthew Damasiewicz and Kerr, {Peter G} and Polkinghorne, {Kevan R}",
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language = "English",
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pages = "65 -- 74",
journal = "Clinical Nephrology",
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}

Vitamin D therapy in chronic kidney disease: back to the future? / Damasiewicz, Matthew; Kerr, Peter G; Polkinghorne, Kevan R.

In: Clinical Nephrology, Vol. 84, No. 2, 2015, p. 65 - 74.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Vitamin D therapy in chronic kidney disease: back to the future?

AU - Damasiewicz, Matthew

AU - Kerr, Peter G

AU - Polkinghorne, Kevan R

PY - 2015

Y1 - 2015

N2 - Deficiency of 1,25(OH)2 vitamin D is inevitable in CKD, and is part of a cascade of bone and mineral abnormalities that result in secondary hyperparathyroidism. The widespread acceptance of calcitriol therapy as the treatment paradigm, has resulted in an overall neglect of vitamin D deficiency, as defined by low serum 25(OH)D levels Recent research has greatly enhanced our understanding of the disordered vitamin D metabolism seen in CKD. Furthermore vitamin D has been implicated in numerous disease states, beyond its traditional role in regulating bone and mineral metabolism. Low serum 25(OH)D levels have been linked to numerous adverse clinical outcomes in health and CKD. Additionally, the recognition of extra-renal, autocrine 1,25(OH)2D synthesis, present in many tissues, has refocused attention on the therapeutic potential of correcting low serum 25(OH)D levels. In this review we examine the physiology of disordered vitamin D metabolism in CKD, the clinical associations of low 25(OH)D levels in CKD, and discuss the rationale for vitamin D replacement in current clinical practice.

AB - Deficiency of 1,25(OH)2 vitamin D is inevitable in CKD, and is part of a cascade of bone and mineral abnormalities that result in secondary hyperparathyroidism. The widespread acceptance of calcitriol therapy as the treatment paradigm, has resulted in an overall neglect of vitamin D deficiency, as defined by low serum 25(OH)D levels Recent research has greatly enhanced our understanding of the disordered vitamin D metabolism seen in CKD. Furthermore vitamin D has been implicated in numerous disease states, beyond its traditional role in regulating bone and mineral metabolism. Low serum 25(OH)D levels have been linked to numerous adverse clinical outcomes in health and CKD. Additionally, the recognition of extra-renal, autocrine 1,25(OH)2D synthesis, present in many tissues, has refocused attention on the therapeutic potential of correcting low serum 25(OH)D levels. In this review we examine the physiology of disordered vitamin D metabolism in CKD, the clinical associations of low 25(OH)D levels in CKD, and discuss the rationale for vitamin D replacement in current clinical practice.

UR - http://www.ncbi.nlm.nih.gov/pubmed/26152127

U2 - 10.5414/CN108519

DO - 10.5414/CN108519

M3 - Article

VL - 84

SP - 65

EP - 74

JO - Clinical Nephrology

JF - Clinical Nephrology

SN - 0301-0430

IS - 2

ER -