Vitamin D in Patients with Chronic Kidney Disease: Nothing New under the Sun
Authors: Marcello Tonelli
Journal: Annals of Internal Medicine (2007)

Editorials18 December 2007Vitamin D in Patients with Chronic Kidney Disease: Nothing New under the SunMarcello Tonelli, MD, SMMarcello Tonelli, MD, SMFrom University of Alberta and Institute of Health Economics, Edmonton, Alberta T6G 2G3, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-12-200712180-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Vitamin D deficiency—a common occurrence in patients with chronic kidney disease—plays an integral role in the development of secondary hyperparathyroidism, which in turn can lead to bone fractures and disability. The active form of vitamin D has hydroxyl groups at the 1 and 25 positions. Current options for vitamin D replacement in patients with chronic kidney disease include nonhydroxylated vitamin D (ergocalciferol, cholecalciferol), 25-hydroxyvitamin D, and activated forms. The latter include 1,25-hydroxyvitamin D and the 1-hydroxylated prohormone, which is subsequently 25-hydroxylated by the liver. Because 1-hydroxylase activity is impaired in chronic kidney disease, activated vitamin D offers theoretical advantages over ...References1. National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003;42:S1-201. [PMID: 14520607] CrossrefMedlineGoogle Scholar2. United States Renal Data System. United States Renal Data System 2007 Annual Data Report. Accessed at www.usrds.org/2007/pdf/11_econ_07.pdf on 10 October 2007. Google Scholar3. Palmer SC, McGregor DO, Macaskill P, Craig JC, Elder GJ, Strippoli GF. Meta-analysis: vitamin D compounds in chronic kidney disease. Ann Intern Med. 2007;147:840-53. LinkGoogle Scholar4. Moe SM, Drüeke TB. 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[PMID: 12490682] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Alberta and Institute of Health Economics, Edmonton, Alberta T6G 2G3, Canada.Grant Support: Dr. Tonelli is supported by salary awards from the Canadian Institutes of Health Research and the Alberta Heritage Foundation for Medical Research.Disclosures: Dr. Tonelli holds peer-reviewed research funding from the Centre for D-Receptor Activation Research to examine vitamin D status in remote-dwelling patients on dialysis.Current Author Address: Marcello Tonelli, MD, SM, 7-129 Clinical Sciences Building, 8440-112 Street, Edmonton, Alberta T6G 2G3, Canada; e-mail, [email protected]ualberta.ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Vitamin D Compounds in Chronic Kidney Disease Suetonia C. Palmer , David O. McGregor , Petra Macaskill , Jonathan C. Craig , Grahame J. Elder , and Giovanni F.M. Strippoli Metrics Cited ByRisk factor analysis of vitamin d insufficiency in end-stage renal disease in CKD patientsComparison of Serum Vitamin D Levels Among Patients With Chronic Kidney Disease, Patients in Dialysis, and Renal Transplant PatientsVitamin D insufficiency and deficiency with stages of chronic kidney disease in an Asian populationInstrumental variable analysisDoes it Matter How Parathyroid Hormone Levels are Suppressed in Secondary Hyperparathyroidism?Symptoms, Differential Diagnosis and ManagementVitamin D and mortality in older men and womenReview article: Addressing risk factors in chronic kidney disease mineral and bone disorder: Can we influence patient-level outcomes?Rheumatic manifestations of renal diseaseThe survival advantage for haemodialysis patients taking vitamin D is questioned: findings from the Dialysis Outcomes and Practice Patterns StudySerum Phosphate Levels and Risk of Infection in Incident Dialysis PatientsReply to Dr S.C. Palmer and co-workersActivated vitamin D sterols in kidney disease 18 December 2007Volume 147, Issue 12Page: 880-881KeywordsBoneCalciumChronic kidney diseaseMedical dialysisPhosphatesRenal diseasesRenal failureSystematic reviewsVitamin D ePublished: 18 December 2007 Issue Published: 18 December 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...