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Vitamin D supplementation for the improvement of vascular function in patients with chronic kidney disease: a meta-analysis of randomized controlled trials

  • Ding Dou
  • Bing Yang
  • Hongqiao Gan
  • Dengpiao Xie
  • Huangwei Lei
  • Naijing YeEmail author
Nephrology - Review
  • 18 Downloads

Abstract

Background

The efficacy of vitamin D on vascular function remains controversial in chronic kidney disease (CKD) patients. The aim of the present work was to perform a meta-analysis of randomized controlled trials to evaluate the efficacy of vitamin D on vascular function in CKD patients.

Methods

We searched Medline, the Cochrane Central Register of Controlled Trials, Embase, the Science Citation Index, and clinical trial registries for randomized controlled trials comparing vitamin D with a placebo in CKD patients.

Results

We included seven trials. For flow-mediated dilation (FMD), there was no significant difference between the two groups (WMD 1.66%; 95% CI − 0.2 to 3.51, p = 0.08; with significant heterogeneity, p < 0.0001, I2 = 89%). We conducted a subgroup analysis. In the cholecalciferol group, compared with the placebo group, cholecalciferol significantly increased FMD (WMD 5.49%; 95% CI 4.36–6.62, p < 0.0001). In the 2 ug paricalcitol group, compared with the placebo group, paricalcitol significantly increased FMD (WMD 2.09%; 95% CI 1.28–2.9, p < 0.0001; without significant heterogeneity, p = 0.47, I2 = 0%). In the 1 ug paricalcitol group, there was no significant difference between the two groups. For pulse wave velocity (PWV), vitamin D significantly decreased PWV compared with the placebo (WMD − 0.93 m/s; 95% CI − 1.71 to − 0.15, p = 0.02; without significant heterogeneity, p = 0.14, I2 = 45%). For calcium (Ca) and parathyroid hormone (PTH), there was a significant difference between the vitamin D group and the placebo group. For 25-hydroxyvitamin D [25(OH)D], there was a significant difference between the inactive vitamin D group and the placebo group. For phosphorus (P), systolic blood pressure (SBP), and diastolic blood pressure (DBP), there were no significant differences between the two groups.

Conclusions

We speculate that vitamin D might be able to improve vascular function in CKD patients. The effect of vitamin D might be associated with its doses and earlier stages of the disease might respond better to vitamin D. Furthermore, trials with larger populations and longer durations are needed in order to provide more reliable evidence.

Keywords

Vitamin D Vascular function Chronic kidney disease 

Notes

Acknowledgements

This work was supported by the Guizhou Provincial Science and Technology Department (Grant No. [2016]7415). The funding agency had no role in the design or conduct of this work.

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Ding Dou
    • 1
    • 2
  • Bing Yang
    • 3
  • Hongqiao Gan
    • 3
  • Dengpiao Xie
    • 4
  • Huangwei Lei
    • 5
  • Naijing Ye
    • 3
    • 4
    Email author
  1. 1.Basic Medical College of Chengdu University of Traditional Chinese MedicineChengduChina
  2. 2.Traditional Chinese Medical Department of Zunyi Medical and Pharmaceutical CollegeZunyiChina
  3. 3.Sichuan 2nd Hospital of Traditional Chinese MedicineChengduChina
  4. 4.Chengdu University of Traditional Chinese MedicineChengduChina
  5. 5.Fujian University of Traditional Chinese MedicineFuzhouChina

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