In a meta-analysis of randomized trials, de Borst and colleagues report that vitamin D therapy reduces proteinuria and might also slow the progression of chronic kidney disease. In light of the limited options for renoprotective therapy, we evaluate whether this evidence for vitamin D treatment justifies a large, definitive trial.
References
de Borst, M. H. et al. Active vitamin D treatment for reduction of residual proteinuria: a systematic review. J. Am. Soc. Nephrol. http://dx.doi.org/10.1681/ASN.2013030203.
Mizobuchi, M. et al. Combination therapy with an angiotensin-converting enzyme inhibitor and a vitamin D analogue suppresses the progression of renal insufficiency in uraemic rats. J. Am. Soc. Nephrol. 18, 1796–1806 (2007).
Lv, J. et al. Antihypertensive agents for preventing diabetic kidney disease. Cochrane Database of Systematic Reviews, Issue 12. Art. No.: CD004136. http://dx.doi.org/10.1002/14651858.CD004136.pub3.
Sharma, P. et al. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non-diabetic chronic kidney disease. Cochrane Database of Systematic Reviews, Issue 10. Art. No.: CD007751. http://dx.doi.org/10.1002/14651858.CD007751.pub2.
Hemmelgarn, B. R. et al. Relation between kidney function, proteinuria, and adverse outcomes. JAMA 303, 423–429 (2010).
Echt, D. S. et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N. Engl. J. Med. 324, 781–788 (1991).
de Zeeuw, D. et al. Selective vitamin D receptor activation with paricalcitol for reduction of albuminuria in patients with type 2 diabetes (VITAL study): a randomised controlled trial. Lancet 376, 1543–1551 (2010).
Mann, J. F. et al. Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial. Lancet 372, 547–553 (2008).
Stevens, L. A., Greene, T. & Levey, A. S. Surrogate end points for clinical trials of kidney disease progression. Clin. J. Am. Soc. Nephrol. 1, 874–884 (2006).
Ruggenenti, P. et al. Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria. Lancet 354, 359–364 (1999).
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Giovanni Strippoli is senior vice president for scientific affairs at Diaverum, a provider of renal services. Suetonia Palmer declares no competing interests.
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Palmer, S., Strippoli, G. Does vitamin D treatment improve outcomes in CKD?. Nat Rev Nephrol 9, 638–640 (2013). https://doi.org/10.1038/nrneph.2013.209
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DOI: https://doi.org/10.1038/nrneph.2013.209
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