Impact of nutritional vitamin D supplementation on parathyroid hormone and 25-hydroxyvitamin D levels in non-dialysis chronic kidney disease : a meta-analysis
Bover, Jordi (Institut d'Investigació Biomèdica Sant Pau)
Gunnarsson, Joel (Quantify Research (Estocolm, Suècia))
Csomor, Philipp (Vifor Pharma (Glattbrugg, Suïssa))
Kaiser, Edelgard (Vifor Pharma (Glattbrugg, Suïssa))
Cianciolo, Giuseppe (Istituto di Ricovero e Cura A Carattere Scientifico (IRCCS))
Lauppe, Rosa (Quantify Research (Estocolm, Suècia))

Data:	2021
Resum:	Background. Secondary hyperparathyroidism (SHPT) is a common and major complication in chronic kidney disease (CKD), reflecting the increase of parathyroid hormone (PTH) in response to reduced vitamin D signalling and hypocalcaemia. This meta-analysis evaluated the impact of nutritional vitamin D (NVD) (cholecalciferol or ergocalciferol) on SHPT-related biomarkers. Methods. A systematic literature search was performed in PubMed to identify relevant randomized control trials to be included in the meta-analysis. Fixed- and random-effects models were used to pool study-level results. Effects were studied within NVD study arms and relative to control groups (placebo/no treatment); the former in order to identify the effect of actively altering biomarkers levels. Results. Reductions in PTH from supplementation with NVD were small when observed within the NVD study arms (pooled reduction: 10. 5 pg/mL) and larger when compared with placebo/no treatment (pooled reduction: 49. 7 pg/mL). NVD supplementation increased levels of 25-hydroxyvitamin D [25(OH)D] in both analyses (increase within NVD study arm: 20. 6 ng/mL, increase versus placebo/no treatment: 26. 9 ng/mL). While small and statistically non-significant changes in phosphate and fibroblast growth factor 23 were observed, NVD supplementation caused calcium levels to increase when compared with placebo/no treatment (increase: 0. 23 mg/dL). Conclusions. Our results suggest that supplementation with NVD can be used to increase 25(OH)D to a certain extent, while the potential of NVD to actively reduce PTH in non-dialysis-CKD patients with SHPT is limited.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Meta-analysis ; Non-dialysis chronic kidney disease ; PTH ; Secondary hyperparathyroidism ; Vitamin D supplementation
Publicat a:	Clinical Kidney Journal, Vol. 14 Núm. 10 (january 2021) , p. 2177-2186, ISSN 2048-8513

DOI: 10.1093/ckj/sfab035
PMID: 34603696

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