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Is Vitamin D Good For Kidney Disease

Renoprotective Mechanisms Of Vitamin D In Experimental Studies

Vitamin D and Renal Disease – Mayo Clinic

Results from animal model studies have suggested the potential renoprotective effects of active vitamin D and its analogues . Beyond its role in calcium and phosphate homeostasis, vitamin D is an important modulator of cellular proliferation, inflammation, differentiation, and immunity . Vitamin D attenuates kidney injury by suppressing fibrosis, inflammation, and apoptosis, by inhibiting multiple pathways known to play a role in kidney injury, including the renin-angiotensin-aldosterone system , the nuclear factor-B , the transforming growth factor- /Smad , and the Wnt/-catenin signaling pathways . Moreover, paricalcitol is an active, nonhypercalcemic vitamin D analogue that shows similar biological activity, with fewer adverse effects and increased tolerance, as compared to those of vitamin D .

Excess Vitamin D Linked To Kidney Damage

Veronica Hackethal, MD

Vitamin D has been reported to have a wide range of benefits. However, a recent case study indicates that excessive use of vitamin D can cause kidney damage in people who are not deficient in the vitamin.

The article was April 8 in the Canadian Medical Association Journal.

“The aim of this case study is to inform a wider audience that vitamin D at large doses in patients with normal serum vitamin D levels can lead to toxicity,” first author Bourne Auguste, MD, University of Toronto, Ontario, Canada, told Medscape Medical News.

“The public should know that taking more vitamin D than is recommended does not necessarily lead to added benefit. Rather, it can lead to increased harm and specifically kidney failure,” he added.

2010 guidelines from Osteoporosis Canada recommend 4001000 IU of vitamin D daily for most adults, and 8002000 IU daily for older adults and those at increased risk for osteoporosis. The US recommended daily intake of vitamin D for males and females between the ages of 1 and 70 years is 600 IU daily and 800 IU for those older than 70 years.

Because vitamin D has a wide therapeutic range, toxicity is rare, Auguste and colleagues note. However, as a fat-soluble vitamin, high doses of it taken for extended periods can lead to buildup.

Why Do I Need Different Amounts Of Vitamins And Minerals

Having chronic kidney disease changes your need for some nutrients. Some of the reasons are:

  • The waste products that build up in your body each day can change the way your body uses vitamins and minerals.
  • Some of the medicines you take can change the way your body uses certain vitamins and minerals.
  • Some vitamins are lost during dialysis treatment if you are on dialysis.
  • Following a special diet for chronic kidney disease can mean you miss certain vitamins and minerals from foods.
  • On days when you may not feel well enough to eat regular meals, you may not get enough daily vitamins and minerals.

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The Kidney Disease Solution Cookbook

The 133-page book is full of recipes that are easy to follow and must incorporate into a kidney-friendly diet. Each recipe is designed to meet the daily nutritional requirements of your body. The book also teaches you how to establish good eating patterns. Whats more, it also includes recipes specifically designed for medical conditions you could have, such as diabetes and hypertension.

Do You Need Supplements

A new role for vitamin D receptor activation in chronic kidney disease ...

Vitamin D supplementation is a controversial topic. The experts who spoke with Healthline held varying views on whether supplementation was necessary.

Dr. Zhaoping Li, director of the UCLA Center for Human Nutrition, is in favor of vitamin D supplementation as long as its done safely under guidance from a physician.

Vitamin D supplementation is important for most of us, as long as we take it responsibly. Side effects are very rare. There is a trend, supported by evidence, to recommended vitamin D supplementation, but that does not mean the more the merrier, she told Healthline.

Many of the experts who spoke with Healthline noted a trend toward people believing vitamins, supplements, or natural treatments are safe and therefore can be taken in high doses.

There seems to be a belief that if a little is good, more must be better, which can cause problems and side effects, as in this case, Dr. Stephen Bent, a professor of medicine, epidemiology, and biostatistics at the University of California, San Francisco, told Healthline.

But Bent says recent research has shown higher levels dont necessarily equate to improved health outcomes.

He notes a randomized controlled trial published this year called the VITAL study that randomly assigned a large group of adults to either a placebo or 2,000 IU of vitamin D per day.

Recommendations for safe daily doses of vitamin D range from 400 to 1,000 IU per day to up to 2,000 IU per day.

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Vitamin D And Cardiovascular Mortality

Four studies reported the HR between active vitamin D treatment and cardiovascular mortality using a crude Cox model and five using an adjusted baseline Cox model. A significant survival advantage was found in patients receiving active vitamin D using an unadjusted analysis and an adjusted analysis . Similar results were found with calcitriol and paricalcitol. The adjusted baseline Cox model analysis found the reduction of cardiovascular mortality with calcitriol and paricalcitol to be 37% and 57% , respectively. There was no survival difference associated with alfacalcidol treatment .

Table 3 Pooled hazard ratio for cardiovascular mortality in patients receiving vitamin D or no treatment

Vitamin D In Chronic Kidney Disease

Diet ManagementFAQTagsdialysis and vitamin Dhyperparathyroidismsunshine vitamintypes of vitamin Dvitamin Dvitamin D and CKD

Vitamin D is a well-knownvitamin that some of us may think of as the sunshine vitamin. In your healthclasses growing up, you were likely taught the role of vitamin D in maintaininghealthy bones.

While vitamin D is vital to bone health, it also has a key relationship with the kidneys. In this article, we will take a look at how kidneys and vitamin D interact, the types of vitamin D and food and supplement sources for vitamin D.

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Rcts With Calcifediol Supplementation

In recent years, preparations of the 25 hydroxylated form of vitamin D, i.e. 25D or calcifediol were developed for oral administration. There are three forms calcifediol and the extended release formula, provided as capsules and the immediate release , provided as a liquid or capsule. The pharmacokinetic profile differs from the parent compound vitamin D. Intestinal absorption of 25D is known to be more efficient and is not dependent on fat absorption, the increase in plasma 25D is more rapid and the doseresponse higher than that of the parent compound. The IR calcifediol formulation was approved in the USA in 1980 for treatment of CKDMBD in dialysis patients . However, it was withdrawn from the market in 2002, since it failed to show meaningful reduction of PTH in patients with CKD G34. IR calcifediol is still available in Europe and licensed for use in various conditions including vitamin D deficiency rickets, renal osteopathy and hypocalcaemia . ER formulations of 25D are only available in the USA at the moment . In 2016 ER calcifediol was approved in the USA to treat SHPT in adult CKD patients G34 and vitamin D insufficiency . Studies in CKD patients showed that ER calcifediol results in a slower increase of 25D levels, more significant suppression of iPTH and less of an increase of 24,25D compared to IR-calcifediol .

Another Paradigm Shift In Vdra Use For Shpt

Vitamin D and its role in Chronic Kidney Disease

In 2009, the KDIGO CKD-MBD guidelines recommended a wider range for PTH target, of 29 the upper limit of normal , relaxing the prescription practice of VDRA and conceivably leading to some reduction in the VDRA doses used in clinical practice. Further, KDIGO CKD-MBD could not recommend a preferred route of administration or a dosing frequency for VDRA.

Advantages of paricalcitol over calcitriol from preclinical studies could not be replicated in humans. In a randomized crossover trial, Hansen et al. showed no difference between alfacalcidol and paricalcitol in the reduction of PTH in dialysis patients. Two other small randomized trials outside the US by Veeri-Haler et al. and by Ong et al. showed that oral paricalcitol has similar efficacy and safety to oral calcitriol in dialysis patients. A recent meta-analysis comparing paricalcitol with other VDR analogs in dialysis patients found no significant differences in the percentage of patients with target reduction of PTH from baseline for paricalcitol and, moreover, no differences in the incidence of hypercalcemia and hyperphosphatemia .

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Who Developed Who Came Up With The Kidney Disease Solution Program

The Kidney Disease Solution was created by Duncan Capicchiano and his wife, Fiona Chin, from Melbourne, Australia. They established a wellness center in Melbourne which has over 13 natural health therapists.

Fully qualified Naturopaths, the two have a common background in herbal and natural therapy.

The program began as an alternative treatment option for Fionas mother, who was suffering from stage-4 renal failure. The couple developed an all-natural program which resulted in the improvement of her condition in just 12 weeks. After 6 months her health improved from stage 4 to stage 1, and she lived healthily for the remainder of 10 years.

After their successes with Fionas mother Fionas grandmother, they decided to create and share their method of treatment with people who are suffering from kidney diseases.

Continue Learning About Kidney Disease

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.

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Rcts: With Calcitriol And Vitamin D Analogues

The active form of vitamin D and its analogues used in the treatment of CKD patients include calcitriol and the vitamin D analogues paricalcitol 2D2) and the 1,252D precursor alfacalcidol D3) . 1,252D3 is identical to the endogenous activated form of calcifediol D3). Paricalcitol and alfacalcidol, the latter of which requires hepatic hydroxylation at the 25 position, are synthetic analogues of vitamin D and are also referred to as vitamin D receptor activators . VDRAs have been used for the management of SHPT in CKD patients for a few decades and show to have reno-protective properties such as reducing albuminuria, renal damage and dysfunction . Paricalcitol suppresses PTH secretion whilst it has a lower stimulatory effect on intestinal absorption of calcium and phosphate compared to 1,252D . Paricalcitol is also associated with reduction of cardiovascular events , although sufficient studies with CKD patients are still lacking.

All twelve studies included CKD patients G34, however, there were differences between studies in patient characteristics. For example, diabetes, established SHPT, use of phosphate binders and proteinuria. The duration of administration varied from 2 to 48 weeks and the dosages used in these studies from 0.25 to 2 g.

All four studies that measured either alkaline phosphatase or bone specific after paricalcitol treatment reported a decrease in this marker of bone metabolism.

Antifibrotic Effects Of Vitamin D And Its Analogues

Renal Supplements

A recent study showed that Wnt/-catenin signaling, which can be inhibited by paricalcitol treatment, plays a critical role in promoting proteinuria and renal fibrosis . Interestingly, our in vitro data indicate that the -catenin signaling pathway may mediate 4-hydroxy-2-hexenal -induced renal tubular EMT, which can be effectively inhibited by paricalcitol-induced VDR/-catenin complex formation in human proximal tubular epithelial cells . Paricalcitol inhibits -catenin-mediated gene transcription by inducing VDR, resulting in sequestration of -catenin transcriptional activity in the nuclei. Overall, the literature has demonstrated that active vitamin D and its analogues can ameliorate renal tubulointerstitial fibrosis or glomerulosclerosis.

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Impact Of Vitamin D On Chronic Kidney Diseases In Non

  • Affiliation Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

  • Affiliation Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

  • Affiliation Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

  • Affiliation Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China

  • Affiliation Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

  • Affiliation Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

  • Affiliation Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

Certain Herbal Supplements And Vitamins

Its important to consult with your doctor before taking any supplements, especially if you are living with chronic disease. Surprising to most, it is not recommended to take some types of herbal supplements and vitamins if youre living with diabetic kidney disease. Certain herbal supplements and vitamins can actually cause further damage to your kidneys. Herbal supplements that your healthcare provider may recommend avoiding include parsley root, astragalus, creatine, licorice root and stinging nettle, but there are many more. Vitamins to limit with DKD include vitamins A, E and K, as these vitamins may accumulate and damage the kidneys.

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Vitamin D Deficiency In Ckd

Recent observations have demonstrated that kidney disease seems to be associated with a high incidence of vitamin D insufficiency or deficiency . Studies by Gonzalez et al. demonstrated that 25-hydroxyvitamin D values are < 30 ng/ml, believed be the lower limit of normal, in the majority of patients with CKD. Patients who are severely proteinuric have the lowest values. These investigators have shown that virtually all of the secondary hyperparathyroidism that occurs in the course of CKD is associated with 25-hydroxyvitamin D values that are < 30 ng/ml. It is interesting to note that in this patient group, there is a positive relationship between 25-hydroxyvitamin D levels and 1, 25-dihydroxyvitamin D levels, in contrast to what is seen in normal individuals. Thus, when 25-hydroxyvitamin D levels are increased by therapy, one would anticipate an increase in the levels in the 1,25-dihydroxyvitamin D. It is not clear whether this is a contribution of renal 1–hydroxylase or the 1–hydroxylase at extrarenal sites however, because of the association of low levels of 25-hydroxyvitamin D with hyperparathyroidism in the course of CKD, it is recommended that in patients with CKD, if hyperparathyroidism is detected, then 25-hydroxyvitamin D should be measured, and if found to be < 30 ng/ml, then the initial step in the therapy should be to try to correct this abnormality, as the first step in the control of hyperparathyroidism.

Use Of Vitamin D Drops Leading To Kidney Failure In A 54

Vitamin D For Kidney Disease! Need it? Should You Take Vitamin K With Vitamin D For Kidney Disease?
        • Vitamin D toxicity is rare, but clinicians must be aware of the risks of vitamin D use to limit complications related to hypercalcemia.

        • Calcium levels may get worse before getting better in patients even after cessation of supplements, as vitamin D is fat soluble.

        • Observational data and expert opinion suggest that glucocorticoids, ketoconazole and hydroxychloroquine are reasonable options to treat hypercalcemia related to vitamin D toxicity by decreasing the active 1, 25 dihydroxyvitamin D3 levels.

        A 54-year-old man was referred urgently to the nephrology clinic by his family physician for suspected acute kidney injury, with a creatinine level of 376 mol/L. He had recently returned from a trip to Southeast Asia, where he had spent extensive periods sunbathing for 2 weeks. His medical history included hypertension, dyslipidemia and gout, for which he was taking perindopril 8 mg daily, rosuvastatin 10 mg daily, amlodipine 10 mg daily, indapamide 2.5 mg daily and febuxostat 80 mg daily.

        The patients family history included autosomal dominant polycystic kidney disease, with 2 first-degree relatives requiring dialysis before age 60. However, he had undergone radiographic screening with abdominal ultrasonography, which was negative for polycystic kidneys.

        Box 1: Relevant serum laboratory values across the patients initial and most recent clinic visits over a 10-month period, with hydroxychloroquine started after his second clinic visit*

        Laboratory test
        60

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            The Kidney Disease Solution Ebook

            This is the most important portion of the program comprising 114 pages, divided into 13 chapters. Its a complete step-by-step guide to the entire program. It includes all the details you need to change your lifestyle and healing your kidneys. The solutions that are provided in the book are backed by the latest research and research, all in an simple language.

            Why Is Knowing About Sodium Important For Someone With Advanced Ckd

            Too much sodium in a persons diet can be harmful because it causes blood to hold fluid. People with CKD need to be careful not to let too much fluid build up in their bodies. The extra fluid raises blood pressure and puts a strain on the heart and kidneys. A dietitian can help people find ways to reduce the amount of sodium in their diet. Nutrition labels provide information about the sodium content in food. The U.S. Food and Drug Administration advises that healthy people should limit their daily sodium intake to no more than 2,300 milligrams , the amount found in 1 teaspoon of table salt. People who are at risk for a heart attack or stroke because of a condition such as high blood pressure or kidney disease should limit their daily sodium intake to no more than 1,500 mg. Choosing sodium-free or low-sodium food products will help them reach that goal.

            Sodium is found in ordinary table salt and many salty seasonings such as soy sauce and teriyaki sauce. Canned foods, some frozen foods, and most processed meats have large amounts of salt. Snack foods such as chips and crackers are also high in salt.

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