Open AccessVitamin D and cardiovascular disease in chronic kidney disease
Author(s) -
Gurpreet Kaur,
Jatinder Singh,
Juhi Kumar
Publication year - 2018
Publication title -
pediatric nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.831
H-Index - 107
eISSN - 1432-198X
pISSN - 0931-041X
DOI - 10.1007/s00467-018-4088-y
Subject(s) - medicine , kidney disease , vitamin d and neurology , nephrology , disease , vitamin d deficiency , randomized controlled trial , endothelial dysfunction , epidemiology , risk factor , clinical trial , intensive care medicine
Chronic kidney disease (CKD) is considered an independent risk factor for cardiovascular disease, with increased cardiovascular morbidity and mortality seen even in the early stages of CKD. Several studies have shown a high prevalence of vitamin D deficiency in individuals with CKD. Low vitamin D levels upregulate the renin-angiotensin-aldosterone system (RAAS), cause endothelial dysfunction, and increase inflammation. Epidemiological studies show an association between vitamin D deficiency and risk factors for cardiovascular disease, but a causal relationship has not been established. The high cardiovascular morbidity and mortality associated with CKD in adults requires therapies to decrease this elevated risk. However, results from several meta-analyses and randomized clinical trials in adults have not shown convincing evidence for the use of vitamin D therapy in improving cardiovascular outcomes. Lack of high-quality evidence from randomized clinical trials in children regarding the effectiveness and long-term safety of vitamin D treatment precludes any recommendations on its use to mitigate the cardiovascular burden of CKD.