[Role of vitamin D in the pathogenesis of chronic kidney disease].

Abstract

Chronic kidney disease (CKD) is a relevant health problem due to its worldwide increasing prevalence and the morbidity and mortality linked to its complications. Since the early stages of CKD, although patients are completely asymptomatic, important mineral homeostasis disorders occur. These disorders, involving serum levels of calcium, phosphorus, parathyroid hormone, and vitamin D, have a striking impact on patient prognosis as they affect the cardiovascular system. The new term of Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD) was introduced to label bone disease during CKD as a systemic disorder tightly linked to cardiovascular calcifications and disabilities. Vitamin D deficiency has a main role in the pathogenesis of CKD-MBD, throughout the pleiotropic actions of this hormone. Vitamin D receptors (VDRs) are ubiquitous and their activation has shown protective effects against secondary hyperparathyroidism development and anti-hypertensive, anti-inflammatory, anti-fibrotic, immunomodulating, anti-proliferative, anti-diabetic and anti-proteinuric properties. These mechanisms explain, at least in part, vitamin D status influence in avoiding and delaying cardiovascular disease and CKD progression. These findings strongly support the importance of an early diagnosis of mineral homeostasis disorders in CKD and the need for correction of vitamin D deficiency to prevent related disabilities and major events.

• Authors: Mario Cozzolino, Francesca Brunini, Valentina Capone, Flavia Ricca, Younes Kwaidri, Emanuele Montanari, Daniele Cusi
• Journal: Recenti progressi in medicina (Recenti Prog Med) Vol. 104 Issue 1 Pg. 33-40 (Jan 2013) ISSN: 0034-1193 [Print] Italy
• Vernacular Title: Ruolo della vitamina D nei pazienti con malattia renale cronica.
• PMID: 23439539 (Publication Type: Journal Article, Review)

Chemical References

• Parathyroid Hormone
• Receptors, Calcitriol
• Vitamin D
• Phosphorus
• 25-hydroxyvitamin D
• Calcium

Topics

• Calcium (blood)
• Cardiovascular Diseases (etiology, physiopathology, prevention & control)
• Chronic Disease
• Diabetes Complications (physiopathology)
• Disease Progression
• Early Diagnosis
• Fibrosis
• Homeostasis
• Humans
• Hyperparathyroidism, Secondary (blood, etiology, prevention & control)
• Hypertension (complications, physiopathology)
• Immune Tolerance (physiology)
• Inflammation (complications, physiopathology)
• Kidney Diseases (blood, etiology, physiopathology)
• Parathyroid Hormone (blood)
• Phosphorus (blood)
• Proteinuria (etiology)
• Receptors, Calcitriol (physiology)
• Vitamin D (analogs & derivatives, blood, physiology, therapeutic use)
• Vitamin D Deficiency (blood, complications, physiopathology)