Vitamin D, Calcium&Mineral Metabolism, Extraskeletal Effects of Vitamin D and the Use of Nutritional Vitamin D in Chronic Kidney Disease
Abstract
Vitamin D is a liposoluble prohormon and and a secosteroid that is produced in the skin after exposure to sunlight. It is turned to calcitriol that has an important role in the calcium and phosphate metabolism by different metabolic pathways.
Vitamin D receptors excluding kidney tissues are available in the following organs and tissues; T lenfosit, brain, prostate, pancreas, gonad, breast tissues, muscles and colon. It is known that function of Vitamin D is not only to maintain healthy bones through arranging calcium homeostasis but also has pro-apopitotic, anti-inflammatory and immune modulator characteristics. In recent epidemiologic studies, low level vitamin D increases cancer incidence and cardiovascular mortality, and comes along with diabetes mellitus, auto-immune diseases such as multiple skleroz.
The development of Chronic Kidney Dissease (CKD) is accompained by a progressive reduce in ability to produce 1,25-dihydroxyvitamin D. Low 25-hydroxyvitamin D levels are common in patients with all stages of CKD and this stuation has been triggered secondary hyperparathyroidism in CKD patients. Extrarenal conversion of 25-hydroxyvitamin D to 1,5-dihydroxyvitamin D may have significant biological role beyond those traditionally ascribed to vitamin D. In this review, we check outed vitamin D, calcium-mineral metabolism, the extrarenal effect of vitamin D, and nutritional vitamin D replacement in CKD.
References
- 1- Dunn PM. Francis Glisson (1597-1677) and the "discovery" of rickets. Arch Dis Child Fetal Neonatal Ed 1998;78:F154–F155. 2- Holick MF, Krane SM, Potts JT. Calcium, phosphorus, and bone metabolism: Calcium-regulation hormones. In: , Fauci AS, Braunwald
- E, Isselbacher KJ, et al (Eds). Harrison's principles of internal medicine. 14th ed. New York: McGraw-Hill; 1995:2214. 3- Behzat Özkan, Hakan Döneray. D vitamininin iskelet sistemi dışı etkileri. Çocuk Sağlığı ve Hastalıkları Dergisi 2011; 54(2): 99-119. 4- Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc 2010;85(8):752. 5- Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc 2011; 86(1):50-60. 6- Thacher TD, Fischer PR, Strand MA, Pettifor JM. Nutritional rickets around the world: causes and future directions. Ann Trop Paediatr 2006; 26(1): 1-16. 7- Bingham CT, Fitzpatrick LA. Noninvasive testing in the diagnosis of osteomacia. Ann J Med 1993;95(5):519-523. 8- Bouillon R. Vitamin D: from photosynthesis, metabolism and action to clinical applications. In: , Jameson JL, De Groot LJ (Eds).
- Endocrinology. Philadelphia;: Saunders Elsevier 2010(1):1089. 9- Muir SW, Montero-Odasso M. Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 2011;59(12):2291-300. 10- Bouillon R, Eelen G, Verlinden L, Mathieu C, Carmeliet G, Verstuyf A. Vitamin D and cancer. J Steroid Biochem Mol Biol 2006;102(1-5):156. 11- Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services
- Task Force. Ann Intern Med 2011;155(12):827. 12- Stolzenberg-Solomon RZ, Vieth R, Azad A, Pietinen P, Taylor
- PR, Virtamo J, Albanes D. A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. Cancer Res 2006;66(20):10213. 13- Bauer SR, Hankinson SE, Bertone-Johnson ER, Ding EL Plasma vitamin D levels, menopause, and risk of breast cancer: doseresponse meta-analysis of prospe.tive studies. Medicine (Baltimore) 2013;92(3):123. 14- Gilbert R, Martin RM, Beynon R, Harris R, Savovic J, Zuccolo
- L, Bekkering GE, Fraser WD, Sterne JA, Metcalfe C. Associations of circulating and dietary vitamin D with prostate cancer risk: a systematic review and dose-response meta-analysis. Cancer Causes Control 2011;22(3):319-40. 15- Ponsonby AL, McMichael A, van der Mei I. Ultraviolet radiation and autoimmune disease: insights from epidemiological research. Toxicology 2002;181-182:71-8. 16- Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio al
- Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr 2002;76(1):187-92. 41- Wolf M, Shah A, Gutierrez O, Ankers E, Monroy M, Tamez H, Steele D, Chang Y, Camargo CA Jr, Tonelli M, Thadhani R. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int 2007;72(8):1004-13( Epub 2007 Aug 8). 42- Nigwekar SU, Bhan I, Thadhani R. Ergocalciferol and cholecalciferol in CKD. Am J Kidney Dis 2012;60(1):139-56 (doi: 1053/j.ajkd.2011.12.035. Epub 2012 May 5. Review). 43- Pilz S, Iodice S, Zittermann A, Grant WB, Gandini S. Vitamin D status and mortality risk in CKD: a meta-analysis of prospective studies. Am J Kidney Dis 2011;58(3):374-82 (doi: 10.1053/j. ajkd.2011.03.020. Epub 2011 Jun 2. Review). 44- Drechsler C, Verduijn M, Pilz S, Dekker FW, Krediet RT, Ritz E, Wanner C, Boeschoten EW, Brandenburg V; NECOSAD Study Group. Vitamin D status and clinical outcomes in incident dialysis patients: results from the NECOSAD study. Nephrol Dial Transplant 2011;26(3):1024-32 ( doi: 10.1093/ndt/gfq606. Epub 2010 Oct 14). 45- Stanbury SW. Azotaemic renal osteodystrophy. Br Med Bull 1957;13(1):57-60. 46- Dent CE, Harper CM, Philpot GR. The treatment of renalglomerular osteodystrophy. Q J Med 1961;30:1-31. 47- Berl T, Berns AS, Hufer WE, Hammill K, Alfrey AC, Arnaud CD, Schrier RW. 1,25 dihydroxycholecalciferol effects in chronic dialysis. A double-blind controlled study.Ann Intern Med 1978;88(6):774-80. 48- Malluche HH, Ritz E, Werner E, Meyer-Sabellek WA. Long-term administration of vitamin D steroles in incipient and advanced renal failure: effect on bone histology. Clin Nephrol 1978;10(6):219-28. 49- Kandula P, Dobre M, Schold JD, Schreiber MJ Jr, Mehrotra R, Navaneethan SD. Vitamin D supplementation in chronic kidney disease: a systematic review and meta-analysis of observational studies and randomized controlled trials. Clin J Am Soc Nephrol 2011;6(1):5062 ( doi: 10.2215/CJN.03940510. Epub 2010 Sep 28).
- Yazışma Adresi/Correspondence Dr. Demet Yavuz Samsun Eğitim Araştırma Hastanesi Nefroloji Kliniği, Samsun, Turkiye, e-mail: demetdolu@hotmail.com Telefon: +90 505 369 16 91 Faks: +90 362 277 90 82 Geliş Tarihi: 25.06.2014 Kabul Tarihi: 01.09.2014
D Vitamini, Kalsiyum & Mineral Metabolizması, D Vitaminin İskelet Dışı Etkileri ve Kronik Böbrek Yetmezliğinde Nutrisyonel D Vitamini Kullanımı
Abstract
Vitamin D, güneş ışığı ile temas sonucu deride üretilen, yağda çözünen, secosteroid yapıda bir prohormondur. Vücutta çeşitli metabolik değişikliklerle kalsitriol olarak bilinen, kalsiyum ve fosfor metabolizmasında önemli rol oynayan bir hormona dönüşür.
Böbrek dokusu haricinde D vitaminine ait reseptörler; T lenfositler, beyin, prostat, pankreas, gonadlar, meme dokusu, kas ve kolon gibi birçok organ ve dokuda bulunmaktadır. D vitamininin etkinliği sadece kalsiyum homeostazisini düzenleyerek kemik sağlığını idame ettirmekle sınırlı olmayıp, aynı zamanda pro-apopitotik, antienflamatuar ve immün-modülatuar özelliklere sahip olduğu bildirilmektedir. Son yıllarda yapılan epidemiyolojik çalışmalarda, düşük D vitamini düzeyinin kanser insidansını ve kardiyovasiküler mortaliteyi arttırdığı, diyabet ve multipl skleroz gibi otoimmün hastalıklar ile birlikte olduğu bildirilmiştir.
Kronik böbrek yetmezliğinin (KBY) gelişmesi ile 1,25 dihidroksi D vitamini üretiminde progresif azalma ile ilişkilidir. Düşük 25-hidroksi vitamin D seviyeleri kronik böbrek yetmezliğinin tüm evrelerinde gözlenmekte ve sekonder hiperparatiroidizme neden olmaktadır. KBY hastalarında bilinen D vitamini önemli biyolojik etkileri, 25 hidroksi vitamin D’nin 1-25 dihidroksi D vitaminine extrarenal dönüşümü sayesinde gerçekleşmektedir. Bu derleme D vitamini, kalsiyum-mineral metabolizması, D vitaminin iskelet dışı etkileri ve kronik böbrek yetmezliğinde nutrisyonel D vitamini kullanımı gözden geçirilmiştir.
References
- 1- Dunn PM. Francis Glisson (1597-1677) and the "discovery" of rickets. Arch Dis Child Fetal Neonatal Ed 1998;78:F154–F155. 2- Holick MF, Krane SM, Potts JT. Calcium, phosphorus, and bone metabolism: Calcium-regulation hormones. In: , Fauci AS, Braunwald
- E, Isselbacher KJ, et al (Eds). Harrison's principles of internal medicine. 14th ed. New York: McGraw-Hill; 1995:2214. 3- Behzat Özkan, Hakan Döneray. D vitamininin iskelet sistemi dışı etkileri. Çocuk Sağlığı ve Hastalıkları Dergisi 2011; 54(2): 99-119. 4- Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc 2010;85(8):752. 5- Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc 2011; 86(1):50-60. 6- Thacher TD, Fischer PR, Strand MA, Pettifor JM. Nutritional rickets around the world: causes and future directions. Ann Trop Paediatr 2006; 26(1): 1-16. 7- Bingham CT, Fitzpatrick LA. Noninvasive testing in the diagnosis of osteomacia. Ann J Med 1993;95(5):519-523. 8- Bouillon R. Vitamin D: from photosynthesis, metabolism and action to clinical applications. In: , Jameson JL, De Groot LJ (Eds).
- Endocrinology. Philadelphia;: Saunders Elsevier 2010(1):1089. 9- Muir SW, Montero-Odasso M. Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 2011;59(12):2291-300. 10- Bouillon R, Eelen G, Verlinden L, Mathieu C, Carmeliet G, Verstuyf A. Vitamin D and cancer. J Steroid Biochem Mol Biol 2006;102(1-5):156. 11- Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services
- Task Force. Ann Intern Med 2011;155(12):827. 12- Stolzenberg-Solomon RZ, Vieth R, Azad A, Pietinen P, Taylor
- PR, Virtamo J, Albanes D. A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. Cancer Res 2006;66(20):10213. 13- Bauer SR, Hankinson SE, Bertone-Johnson ER, Ding EL Plasma vitamin D levels, menopause, and risk of breast cancer: doseresponse meta-analysis of prospe.tive studies. Medicine (Baltimore) 2013;92(3):123. 14- Gilbert R, Martin RM, Beynon R, Harris R, Savovic J, Zuccolo
- L, Bekkering GE, Fraser WD, Sterne JA, Metcalfe C. Associations of circulating and dietary vitamin D with prostate cancer risk: a systematic review and dose-response meta-analysis. Cancer Causes Control 2011;22(3):319-40. 15- Ponsonby AL, McMichael A, van der Mei I. Ultraviolet radiation and autoimmune disease: insights from epidemiological research. Toxicology 2002;181-182:71-8. 16- Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio al
- Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr 2002;76(1):187-92. 41- Wolf M, Shah A, Gutierrez O, Ankers E, Monroy M, Tamez H, Steele D, Chang Y, Camargo CA Jr, Tonelli M, Thadhani R. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int 2007;72(8):1004-13( Epub 2007 Aug 8). 42- Nigwekar SU, Bhan I, Thadhani R. Ergocalciferol and cholecalciferol in CKD. Am J Kidney Dis 2012;60(1):139-56 (doi: 1053/j.ajkd.2011.12.035. Epub 2012 May 5. Review). 43- Pilz S, Iodice S, Zittermann A, Grant WB, Gandini S. Vitamin D status and mortality risk in CKD: a meta-analysis of prospective studies. Am J Kidney Dis 2011;58(3):374-82 (doi: 10.1053/j. ajkd.2011.03.020. Epub 2011 Jun 2. Review). 44- Drechsler C, Verduijn M, Pilz S, Dekker FW, Krediet RT, Ritz E, Wanner C, Boeschoten EW, Brandenburg V; NECOSAD Study Group. Vitamin D status and clinical outcomes in incident dialysis patients: results from the NECOSAD study. Nephrol Dial Transplant 2011;26(3):1024-32 ( doi: 10.1093/ndt/gfq606. Epub 2010 Oct 14). 45- Stanbury SW. Azotaemic renal osteodystrophy. Br Med Bull 1957;13(1):57-60. 46- Dent CE, Harper CM, Philpot GR. The treatment of renalglomerular osteodystrophy. Q J Med 1961;30:1-31. 47- Berl T, Berns AS, Hufer WE, Hammill K, Alfrey AC, Arnaud CD, Schrier RW. 1,25 dihydroxycholecalciferol effects in chronic dialysis. A double-blind controlled study.Ann Intern Med 1978;88(6):774-80. 48- Malluche HH, Ritz E, Werner E, Meyer-Sabellek WA. Long-term administration of vitamin D steroles in incipient and advanced renal failure: effect on bone histology. Clin Nephrol 1978;10(6):219-28. 49- Kandula P, Dobre M, Schold JD, Schreiber MJ Jr, Mehrotra R, Navaneethan SD. Vitamin D supplementation in chronic kidney disease: a systematic review and meta-analysis of observational studies and randomized controlled trials. Clin J Am Soc Nephrol 2011;6(1):5062 ( doi: 10.2215/CJN.03940510. Epub 2010 Sep 28).
- Yazışma Adresi/Correspondence Dr. Demet Yavuz Samsun Eğitim Araştırma Hastanesi Nefroloji Kliniği, Samsun, Turkiye, e-mail: demetdolu@hotmail.com Telefon: +90 505 369 16 91 Faks: +90 362 277 90 82 Geliş Tarihi: 25.06.2014 Kabul Tarihi: 01.09.2014
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Reviews |
| Authors | |
| Publication Date | June 25, 2014 |
| Published in Issue | Year 2014 Volume: 14 Issue: 4 |
