Vitamin D therapy in chronic kidney disease: a critical appraisal of clinical trial evidence

Wing-Chi G Yeung; Nigel D Toussaint; Sunil V Badve

doi:10.1093/ckj/sfae227

Vitamin D therapy in chronic kidney disease: a critical appraisal of clinical trial evidence

Clin Kidney J. 2024 Jul 18;17(8):sfae227. doi: 10.1093/ckj/sfae227. eCollection 2024 Aug.

Authors

Wing-Chi G Yeung^{1

2

3}, Nigel D Toussaint^{4

5}, Sunil V Badve^{2

3

6}

Affiliations

¹ Department of Nephrology, Wollongong Hospital, Wollongong, New South Wales, Australia.
² Renal and Metabolic Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
³ Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
⁴ Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁵ Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia.
⁶ Department of Nephrology, St George Hospital, Sydney, New South Wales, Australia.

Abstract

In people with chronic kidney disease (CKD), the physiology of vitamin D is altered and leads to abnormalities in bone and mineral metabolism which contribute to CKD mineral and bone disorder (CKD-MBD). Observational studies show an association between vitamin D deficiency and increased risk of mortality, cardiovascular disease and fracture in CKD. Although vitamin D therapy is widely prescribed in people with CKD, clinical trials to date have failed to demonstrate a clear benefit of either nutritional vitamin D supplementation or active vitamin D therapy in improving clinical outcomes in CKD. This review provides an updated critical analysis of recent trial evidence on vitamin D therapy in people with CKD.

Keywords: CKD-MBD; bone health; cardiovascular disease; chronic kidney disease; vitamin D.

Publication types

Review