Open AccessImpact of nutritional vitamin D supplementation on parathyroid hormone and 25-hydroxyvitamin D levels in non-dialysis chronic kidney disease: a meta-analysis
Author(s) -
Jordi Bover,
Joel Gunnarsson,
Philipp A. Csomor,
E. Kaiser,
Giuseppe Cianciolo,
Rosa Lauppe
Publication year - 2021
Publication title -
clinical kidney journal
Language(s) - English
Resource type - Journals
eISSN - 2048-8513
pISSN - 2048-8505
DOI - 10.1093/ckj/sfab035
Subject(s) - secondary hyperparathyroidism , medicine , cinacalcet , vitamin d and neurology , placebo , kidney disease , parathyroid hormone , endocrinology , fibroblast growth factor 23 , hyperparathyroidism , vitamin d deficiency , dialysis , paricalcitol , meta analysis , calcium , pathology , alternative medicine
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.