Financiado en parte por Amgen
Vitamin D supplementation in chronic kidney disease: a systematic review and meta-analysis of observational studies and randomized controlled trials
Kandula P, Dobre M, Schold JD, Schreiber MJ, Mehrotra R, Navaneethan SD
Clinical journal of the American Society of Nephrology : CJASN · 209 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiado por la industria
- Empresa
- Amgen
- Universidad u hospital
- Cleveland Clinic
- Gobierno
- National Center for Research Resources
- Gobierno
- NCRR NIH HHS
- Subvenciones
- National Center for Research Resources (KL2-RR-024990); National Center for Research Resources (RR024990)
Según 4 financiadores declarados.
Publicación
- Publicado
- 2010-09-28 · Clin J Am Soc Nephrol · vol. 6 · número 1 · págs. 50–62
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 302 citas · más que el 99% de estudios similares · 17.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 58 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Parathyroid Disorders and Treatments · Vitamin D Research Studies · Dialysis and Renal Disease Management
- Palabras clave
- vitamin D supplementation, chronic kidney disease, vitamin D deficiency, 25-hydroxyvitamin D, parathyroid hormone, dialysis, kidney transplant recipients, hypercalcemia, hyperphosphatemia, vitamin D2, vitamin D3
- MeSH
- kidney diseases, kidney failure, chronic, chronic disease, calcium, phosphorus, parathyroid hormone, fibroblast growth factors, vitamin d, dietary supplements, randomized controlled trials as topic, fibroblast growth factor-23
6 autores
- Praveen Kandula🇺🇸 · autor de correspondenciaIndiana University Indianapolis
- Mirela A. Dobre🇺🇸Huron Hospital; Case Western Reserve University
- Jesse D. Schold🇺🇸Cleveland Clinic
- Martin J. Schreiber
- Rajnish Mehrotra🇺🇸 · autor de correspondenciaUniversity of California, Los Angeles; The Lundquist Institute; Los Angeles Medical Center; Harbor–UCLA Medical Center; Indiana University Indianapolis
- Sankar Dass Navaneethan
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background and objectives
Vitamin D deficiency is highly prevalent among patients with chronic kidney disease (CKD). The benefits and harms of vitamin D supplementation (ergocalciferol or cholecalciferol) were assessed in patients with nondialysis-dependent CKD, dialysis-dependent CKD, and renal transplant recipients.
Design, setting, participants, & measurements
MEDLINE (1966 to September 2009), SCOPUS (September 2009), and nephrology conference proceedings were searched for relevant observational and randomized controlled trials (RCTs). Treatment effects were summarized as mean differences (MDs) with 95% confidence intervals (CIs) using a random effects model. Separate analyses were conducted for observational studies and RCTs.
Results
Twenty-two studies (17 observational and 5 RCTs) were included. There was a significant improvement in 25-hydroxyvitamin D (MD 24.1 ng/ml, 95% CI 19.6 to 28.6) and an associated decline in parathyroid hormone (PTH) levels (MD -41.7 pg/ml, 95% CI -55.8 to -27.7) among observational studies. PTH reduction was higher in dialysis patients. Among RCTs, there was a significant improvement in 25-hydroxyvitamin D (MD 14 ng/ml, 95% CI 5.6 to 22.4) and an associated decline in PTH levels (MD -31.5 pg/ml, 95% CI -57 to -6.1). A low incidence of hypercalcemia and hyperphosphatemia was reported with vitamin D supplementation. Cardiovascular and skeletal effects of vitamin D supplementation have not been studied. Included studies were mostly of low to moderate quality.
Conclusions
Available evidence from low-to-moderate quality observational studies and fewer RCTs suggests that vitamin D supplementation improves biochemical endpoints. However, whether such improvements translate into clinically significant outcomes is yet to be determined.
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