Abstract
In terms of both exogenous sources (diet), and endogenous production (activation through exposure to ultraviolet light), vitamin D is unique. Few foods naturally contain vitamin D and only a few are fortified with vitamin D. Most people get more than 90% of their vitamin D requirements from exposure to sunlight. Those who protect their skin from ultraviolet-B radiation with clothing or sunscreen, the elderly, and dark-skinned individuals have limited capacity to produce vitamin D. Vitamin D deficiency is common in the general population and even more common in patients with chronic renal failure (CKD). Increased use of sun-blocking agents and decreased exposure to sunlight, to reduce the risk of skin cancer, attributed to exposure to UV radiation, may contribute to the increase in vitamin D deficiency in the population. These issues are particularly important in the dialysis population who are at particular risk because these, mostly elderly, individuals have an inactive life style and have reduced exposure to sunshine and UV light, thus limiting the actinic synthesis of vitamin D. The nephrology community seems to have overlooked the importance of vitamin D for overall health and well being in patients with CKD. Recently however, several authors have called attention to the role of plasma 25(OH)D3 levels in mineral metabolism dysregulation in patients with chronic kidney diseases, and those on dialysis. Vitamin D not only contributes to skeletal health but also plays a major role in the health of a wide variety of other organ systems. It seems that vitamin D supplementation is the most effective way of preventing vitamin D deficiency.
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References
MF Holick (2003) ArticleTitleVitamin D: a millenium perspective J Cell Biochem 88 296–307 Occurrence Handle12520530 Occurrence Handle1:CAS:528:DC%2BD3sXntlyksQ%3D%3D Occurrence Handle10.1002/jcb.10338
MF Holick (2002) ArticleTitleVitamin D: the underappreciated D-lightf hormone that is important for skeletal and cellular health Curr Opin Endocrinol Diabetes 9 87–98 Occurrence Handle1:CAS:528:DC%2BD38Xnt1alu70%3D Occurrence Handle10.1097/00060793-200202000-00011
WE Stumpf M Sar FA Reid et al. (1979) ArticleTitleTarget cells for 1,25-dihydroxyvitamin D3 in intestinal tract, stomach, kidney, skin, pituitary, and parathyroid Science 206 1188–1190 Occurrence Handle505004 Occurrence Handle1:CAS:528:DyaL3cXlt1entw%3D%3D
H Tanaka E Abe C Miyaura et al. (1982) ArticleTitle1,25-dihydroxycholeciferol and human myeloid leukemia cell line (HL-60): the presence of cytosol receptor and induction of differentiation Biochem J 204 713–719 Occurrence Handle6289803 Occurrence Handle1:CAS:528:DyaL38XltVCksLk%3D
EL Smith ND Walworth MF Holick (1986) ArticleTitleEffect of 1,25-dihydroxyvitamin D3 on the morphologic and biochemical differentiation of cultured human epidermal keratinocytes grown in serum-free conditions J Invest Dermatol 86 709–714 Occurrence Handle2423618 Occurrence Handle1:CAS:528:DyaL28XktF2nsrk%3D Occurrence Handle10.1111/1523-1747.ep12276343
AS Dusso J Finch A Brown et al. (1991) ArticleTitleExtrarenal production of calcitriol in normal and uremic humans J Clin Endocrinol Metab 72 157–164 Occurrence Handle1986015 Occurrence Handle1:STN:280:DyaK3M%2FptleltQ%3D%3D
V Tangpricha JN Flanagan LW Whitlatch et al. (2001) ArticleTitle25-hydroxyvitamin D-1α-hydroxylase in normal and malignant colon tissue Lancet 357 1673–1674 Occurrence Handle11425375 Occurrence Handle1:CAS:528:DC%2BD3MXks1Knu70%3D Occurrence Handle10.1016/S0140-6736(00)04831-5
YR Lou S Qiao R Talonpoika et al. (2004) ArticleTitle25-Hydroxyvitamin D3 is an active hormone in human primary prostatic stromal cells FASEB J 18 332–334 Occurrence Handle14657005 Occurrence Handle1:CAS:528:DC%2BD2cXht1Gjtro%3D
(2003) National Kidney Foundation K-DOQI clinical practise guidelines for bone metabolism and disese. Am J Kidney Dis 2(Suppl 3):7–201
S Nesby-O‘Dell KS Scanlon ME Cogswell et al. (2002) ArticleTitleHypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third national health and nutrition examination survey, 1988–1994 Am J Clin Nutr 76 187–192 Occurrence Handle12081833 Occurrence Handle1:CAS:528:DC%2BD38XltVyhu7g%3D
V Tangpricha EN Pearce TC Chen et al. (2002) ArticleTitleVitamin D insufficiency among free-living healthy young adults Am J Med 112 IssueID8 659–662 Occurrence Handle12034416 Occurrence Handle1:CAS:528:DC%2BD38XktVCitrg%3D Occurrence Handle10.1016/S0002-9343(02)01091-4
RP Wielen ParticleVan der MR Lowik H Berg ParticleVan den et al. (1995) ArticleTitleSerum vitamin D concentrations among elderly people in Europe Lancet 346 207–210 Occurrence Handle7616799 Occurrence Handle10.1016/S0140-6736(95)91266-5
MK Thomas DM Lloyd-Jones RI Thadhani et al. (1998) ArticleTitleHypovitaminosis D in medical inpatients N Engl J Med 338 777–783 Occurrence Handle9504937 Occurrence Handle1:STN:280:DyaK1c7lvVSgsw%3D%3D Occurrence Handle10.1056/NEJM199803193381201
EA Gonzalez A Sachdeva DA Oliver KJ Martin (2004) ArticleTitleVitamin D Insufficiency and deficiency in chronic kidney disease Am J Nephrol 4 503–510
RE LaClair RN Hellman SL Karp et al. (2005) ArticleTitlePrevalence of calcidiol deficiency in CKD: a cross-sectional study across latitudes in the US Am J Kidney Dis 45 IssueID6 1026–1033 Occurrence Handle15957131 Occurrence Handle1:CAS:528:DC%2BD2MXlvVSjs74%3D Occurrence Handle10.1053/j.ajkd.2005.02.029
JA MacLaughlin RR Anderson MF Holick (1982) ArticleTitleSpectral character of sunlight modulates photosynthesis of previtamin D3 and its photoisomers in human skin Science 216 1001–1004 Occurrence Handle6281884 Occurrence Handle1:CAS:528:DyaL38XktVaqt7k%3D
AR Webb L Kline MF Holick (1988) ArticleTitleInfluence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin J Clin Endocrinol Metab 67 373–378 Occurrence Handle2839537 Occurrence Handle1:CAS:528:DyaL1cXkvFWltbs%3D
TL Clemens SL Henderson JS Adams MF Holick (1982) ArticleTitleIncreased skin pigment reduces the capacity of skin to synthesise vitamin D3 Lancet 6 74–76 Occurrence Handle10.1016/S0140-6736(82)90214-8
LY Matsuoka J Wortsman MJ Dannenberg et al. (1992) ArticleTitleClothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin D3 J Clin Endocrinol Metab 75 IssueID4 1099–1103 Occurrence Handle1328275 Occurrence Handle1:STN:280:DyaK3s%2Fhs1KhtA%3D%3D Occurrence Handle10.1210/jc.75.4.1099
LY Matsuoka L Ide J Wortsman et al. (1987) ArticleTitleSunscreens suppress cutaneous vitamin D3 synthesis J Clin Endocrinol Metab 64 1165–1168 Occurrence Handle3033008 Occurrence Handle1:CAS:528:DyaL2sXkt1yiu78%3D Occurrence Handle10.1210/jcem-64-6-1165
J MacLaughlin MF Holick (1985) ArticleTitleAging decreases the capacity of human skin to produce vitamin D3 J Clin Invest 6 1536–1538
MF Holick (1987) ArticleTitlePhotosynthesis of vitamin D in the skin: effect of environmental and life-style variables Fed Proc 46 IssueID5 1876–1882 Occurrence Handle3030826 Occurrence Handle1:CAS:528:DyaL2sXkt1WjtL0%3D
MC Chapuy P Preziosi M Maamer et al. (1997) ArticleTitlePrevalence of vitamin D insufficiency in an adult normal population Osteoporos Int 7 439–443 Occurrence Handle9425501 Occurrence Handle1:STN:280:DyaK1c%2Fos1Kgug%3D%3D Occurrence Handle10.1007/s001980050030
JW Coburn MH Koppel AS Brickman SG Massry (1973) ArticleTitleStudy of intestinal absorption of calcium in patients with renal failure Kidney Int 3 264–272 Occurrence Handle4600294 Occurrence Handle1:CAS:528:DyaE3sXktFKmt7o%3D
KG Koenig JS Lindberg JE Zerwekh et al. (1992) ArticleTitleFree and total 1,25-dihydroxyvitamin D levels in subjects with renal disease Kidney Int 41 161–165 Occurrence Handle1593853 Occurrence Handle1:STN:280:DyaK383nsl2rsw%3D%3D
H Saha (1994) ArticleTitleCalcium and vitamin D homeostasis in patients with heavy proteinuria Clin Nephrol 41 290–296 Occurrence Handle8050209 Occurrence Handle1:STN:280:DyaK2czis1Ckug%3D%3D
JB Eastwood E Harris Tcb HE Stamp Wardener ParticleDe (1976) ArticleTitleVitamin-D deficiency in the osteomalacia of chronic renal failure Lancet 2 1209–1211 Occurrence Handle63038 Occurrence Handle1:STN:280:DyaE2s%2FlsFWrtg%3D%3D Occurrence Handle10.1016/S0140-6736(76)91140-5
A Ghazali P Fardellone A Pruna et al. (1999) ArticleTitleIs low plasma 25-(OH) vitamin D a major risk factor for hyperparathyroidism and Looser’s zones independent of calcitriol? Kidney Int 55 2169–2177 Occurrence Handle10354266 Occurrence Handle1:STN:280:DyaK1M3ot12rug%3D%3D Occurrence Handle10.1046/j.1523-1755.1999.00480.x
DE Memmos JB Eastwood E Harris et al. (1982) ArticleTitleResponse of uremic osteoid to vitamin D Kidney Int 11 50–54
A Dusso S Lopez-Hilker N Rapp E Slatopolsky (1988) ArticleTitleExtra-renal production of calcitriol in chronic renal failure Kidney Int 34 368–375 Occurrence Handle3172645 Occurrence Handle1:STN:280:DyaL1M%2Fht1Omsw%3D%3D
PW Lambert PH Stern RC Avioli et al. (1982) ArticleTitleEvidence for extrarenal production of 1 alpha,25-dihydroxyvitamin D in man J Clin Invest 69 722–725 Occurrence Handle6895901 Occurrence Handle1:CAS:528:DyaL38XhtlKrsLc%3D
E Ishimura Y Nishizawa M Inaba et al. (1999) ArticleTitleSerum levels of 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D, and 25-hydroxyvitamin D in nondialyzed patients with chronic renal failure Kidney Int 55 1019–1027 Occurrence Handle10027939 Occurrence Handle1:STN:280:DyaK1M7lt1ahtw%3D%3D Occurrence Handle10.1046/j.1523-1755.1999.0550031019.x
J Cunningham H Makin (1997) ArticleTitleHow important is vitamin D deficiency in uremia? Nephrol Dial Transplant 12 16–18 Occurrence Handle9027765 Occurrence Handle1:CAS:528:DyaK2sXhs1OjsLo%3D Occurrence Handle10.1093/ndt/12.1.16
F Qaw MJ Calverley NJ Schroeder et al. (1993) ArticleTitleIn vivo metabolism of the vitamin D analog, dihydrotachysterol: Evidence for formation of 1 alpha, 25- and 1 beta, 25-dihydrotachysterol metabolites and studies of their biological activity J Biol Chem 268 282–292 Occurrence Handle8380156 Occurrence Handle1:CAS:528:DyaK3sXjs1KksA%3D%3D
R Phadnis I Nemere (2003) ArticleTitleDirect rapid effects of 25-hydroxyvitamin D3 on isolated intestinal cells Cell Biochem 90 IssueID2 287–293 Occurrence Handle1:CAS:528:DC%2BD3sXotlGmsr4%3D Occurrence Handle10.1002/jcb.10639
MM Popovtzer J Levi Y Bar-Khayim et al. (1992) ArticleTitleAssessment of combined 24,25(OH)2D3 and 1 alpha (OH)D3 therapy for bone disease in dialysis patients Bone 13 IssueID5 369–377 Occurrence Handle1419378 Occurrence Handle1:STN:280:DyaK3s%2FktVOisg%3D%3D Occurrence Handle10.1016/8756-3282(92)90453-4
JM Pettifor DD Bikle M Cavaleros et al. (1995) ArticleTitleSerum levels of free 1,25-dihydroxyvitamin D in vitamin D toxicity Ann Intern Med 122 IssueID7 5111–5133
A Fournier PH Bordier J Gueris et al. (1979) ArticleTitleComparison of 1-alphahydroxy-cholecalciferol and 25 hydroxy-cholecalciferol in the treatment of renal osteodystrophy: Greater effect of 25 hydroxy- cholecalciferol on bone mineralization Kidney Int 15 196–204 Occurrence Handle513484 Occurrence Handle1:STN:280:DyaL3c%2FnsFyltA%3D%3D
JB Eastwood PJ Bordier EM Clarkson et al. (1974) ArticleTitleThe contrasting effect on bone histology of vitamin D and of calcium carbonate in the osteomalacia of chronic renal failure Clin Sci Mol Med 47 23–42 Occurrence Handle4854694 Occurrence Handle1:STN:280:DyaE2czgvVaqsg%3D%3D
A Fournier A Idrissi JL Sebert et al. (1988) ArticleTitlePreventing renal bone disease in moderate renal failure with CaCO3 and 25 OH vitamin D3 Kidney Int 33 IssueIDSuppl 24 178–179
E Ritz R Boland W Kreusser (1980) ArticleTitleEffects of vitamin D and parathyroid hormone on muscle: potential role in uremic myopathy Am J Clin Nutr 33 IssueID7 1522–1529 Occurrence Handle6772012 Occurrence Handle1:CAS:528:DyaL3cXlsVOnsro%3D
SJ Birge JG Haddad (1975) ArticleTitle25-hydroxycholecalciferol stimulation of muscle metabolism Clin Invest. 56 IssueID5 1100–1107 Occurrence Handle1:CAS:528:DyaE28XisF2nuw%3D%3D Occurrence Handle10.1172/JCI108184
H Taskapan FF Ersoy P Passadakis et al. (2005) ArticleTitleBody pain during daily activities in patients on peritoneal dialysis Dialysis Transplant 2 58–72
N Shah J Bernardini B Piraino (2005) ArticleTitlePrevalence and correction of 25(OH) vitamin D deficiency in peritoneal dialysis patients Perit Dial Int 25 362–366 Occurrence Handle16022093 Occurrence Handle1:CAS:528:DC%2BD2MXmvF2rurs%3D
SC Manolagas DM Provvedini CD Tsoukas (1985) ArticleTitleInteractions of 1,25-dihydroxyvitamin D3 and the immune system Mol Cell Endocrinol 43 113–122 Occurrence Handle3000847 Occurrence Handle1:CAS:528:DyaL28XivVyrsA%3D%3D Occurrence Handle10.1016/0303-7207(85)90074-7
FL Apperly (1941) ArticleTitleThe relation of solar radiation to cancer mortality in North America Cancer Res 1 191–195
FC Garland CF Garland ED Gorham JF Young (1990) ArticleTitleGeographic variation in breast cancer mortality in the US: a hypothesis involving exposure to solar radiation Prev Med 19 614–622 Occurrence Handle2263572 Occurrence Handle1:STN:280:DyaK3M%2FovVCrtg%3D%3D Occurrence Handle10.1016/0091-7435(90)90058-R
CL Hanchette GG Schwartz (1992) ArticleTitleGeographic patterns of prostate cancer mortality Cancer 70 2861–2869 Occurrence Handle1451068 Occurrence Handle1:STN:280:DyaK3s%2Fot1Khtw%3D%3D Occurrence Handle10.1002/1097-0142(19921215)70:12<2861::AID-CNCR2820701224>3.0.CO;2-G
MR Hussein (2005) ArticleTitleUltraviolet radiation and skin cancer: molecular mechanisms J Cutan Pathol 32 IssueID3 191–205 Occurrence Handle15701081 Occurrence Handle10.1111/j.0303-6987.2005.00281.x
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Taskapan, H., Wei, M. & Oreopoulos, D.G. 25(OH) Vitamin D3 in patients with chronic kidney disease and those on dialysis: rediscovering its importance. Int Urol Nephrol 38, 323–329 (2006). https://doi.org/10.1007/s11255-006-0081-7
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DOI: https://doi.org/10.1007/s11255-006-0081-7