The effect of cholecalciferol for lowering albuminuria in chronic kidney disease: a prospective controlled study
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Title: | The effect of cholecalciferol for lowering albuminuria in chronic kidney disease: a prospective controlled study |
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Authors: | Molina, Pablo | Górriz, José L. | Molina Vila, Mariola D. | Peris, Ana | Beltrán, Sandra | Kanter, Julia | Escudero, Verónica | Romero, Ramón | Pallardó, Luis M. |
Research Group/s: | Laboratorio de Optimización (LOPT) |
Center, Department or Service: | Universidad de Alicante. Departamento de Estadística e Investigación Operativa |
Keywords: | Albuminuria | Chronic kidney disease | Hyperparathyroidism | Vitamin D |
Knowledge Area: | Estadística e Investigación Operativa |
Issue Date: | Jan-2014 |
Publisher: | Oxford University Press |
Citation: | Nephrology Dialysis Transplantation. 2014, 29(1): 97-109. doi:10.1093/ndt/gft360 |
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. |
URI: | http://hdl.handle.net/10045/39462 |
ISSN: | 0931-0509 (Print) | 1460-2385 (Online) |
DOI: | 10.1093/ndt/gft360 |
Language: | eng |
Type: | info:eu-repo/semantics/article |
Rights: | © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA |
Peer Review: | si |
Publisher version: | http://dx.doi.org/10.1093/ndt/gft360 |
Appears in Collections: | INV - LOPT - Artículos de Revistas INV - AppBiochem - Artículos de Revistas INV - AppBiochem - Artículos de Revistas INV - GESTA - Artículos de Revistas |
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2014_Molina_etal_NDT_final.pdf | Versión final (acceso restringido) | 395,46 kB | Adobe PDF | Open Request a copy |
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