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A Randomized Trial of Vitamin D Supplementation on Vascular Function in CKD.
J Am Soc Nephrol. 2017 Oct; 28(10):3100-3108.JA

Abstract

Vitamin D deficiency associates with mortality in patients with CKD, and vitamin D supplementation might mitigate cardiovascular disease risk in CKD. In this randomized, double-blind, placebo-controlled trial, we investigated the effect of cholecalciferol supplementation on vascular function in 120 patients of either sex, aged 18-70 years, with nondiabetic CKD stage 3-4 and vitamin D deficiency (serum 25-hydroxyvitamin D ≤20 ng/ml). We randomized patients using a 1:1 ratio to receive either two directly observed oral doses of cholecalciferol (300,000 IU) or matching placebo at baseline and 8 weeks. The primary outcome was change in endothelium-dependent brachial artery flow-mediated dilation at 16 weeks. Secondary outcome measures included changes in pulse wave velocity and circulating biomarkers. Cholecalciferol supplementation significantly increased endothelium-dependent brachial artery flow-mediated dilation at 16 weeks, whereas placebo did not (between-group difference in mean change: 5.49%; 95% confidence interval, 4.34% to 6.64%; P<0.001). Intervention also led to significant favorable changes in pulse wave velocity and circulating IL-6 levels. Thus, in nondiabetic patients with stage 3-4 CKD and vitamin D deficiency, vitamin D supplementation may improve vascular function. This study is registered with the Clinical Trials Registry of India (no.: CTRI/2013/05/003648).

Authors+Show Affiliations

Departments of Nephrology and.Departments of Nephrology and.Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.Departments of Nephrology and.Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.George Institute for Global Health, Sydney, New South Wales, Australia. Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.Departments of Nephrology and.Renal and Transplantation Unit, St. George's University Hospitals National Health Service Foundation Trust, London, UK. Molecular and Clinical Sciences Research Institute, St. George's, University of London, London, UK.Departments of Nephrology and vjha@pginephro.org. George Institute for Global Health, New Delhi, India; and. George Institute for Global Health, University of Oxford, Oxford, UK.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28667080

Citation

Kumar, Vivek, et al. "A Randomized Trial of Vitamin D Supplementation On Vascular Function in CKD." Journal of the American Society of Nephrology : JASN, vol. 28, no. 10, 2017, pp. 3100-3108.
Kumar V, Yadav AK, Lal A, et al. A Randomized Trial of Vitamin D Supplementation on Vascular Function in CKD. J Am Soc Nephrol. 2017;28(10):3100-3108.
Kumar, V., Yadav, A. K., Lal, A., Kumar, V., Singhal, M., Billot, L., Gupta, K. L., Banerjee, D., & Jha, V. (2017). A Randomized Trial of Vitamin D Supplementation on Vascular Function in CKD. Journal of the American Society of Nephrology : JASN, 28(10), 3100-3108. https://doi.org/10.1681/ASN.2017010003
Kumar V, et al. A Randomized Trial of Vitamin D Supplementation On Vascular Function in CKD. J Am Soc Nephrol. 2017;28(10):3100-3108. PubMed PMID: 28667080.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Randomized Trial of Vitamin D Supplementation on Vascular Function in CKD. AU - Kumar,Vivek, AU - Yadav,Ashok Kumar, AU - Lal,Anupam, AU - Kumar,Vinod, AU - Singhal,Manphool, AU - Billot,Laurent, AU - Gupta,Krishan Lal, AU - Banerjee,Debasish, AU - Jha,Vivekanand, Y1 - 2017/06/30/ PY - 2017/01/02/received PY - 2017/05/03/accepted PY - 2017/7/2/pubmed PY - 2017/10/20/medline PY - 2017/7/2/entrez KW - Vitamin D KW - cardiovascular disease KW - chronic kidney disease SP - 3100 EP - 3108 JF - Journal of the American Society of Nephrology : JASN JO - J Am Soc Nephrol VL - 28 IS - 10 N2 - Vitamin D deficiency associates with mortality in patients with CKD, and vitamin D supplementation might mitigate cardiovascular disease risk in CKD. In this randomized, double-blind, placebo-controlled trial, we investigated the effect of cholecalciferol supplementation on vascular function in 120 patients of either sex, aged 18-70 years, with nondiabetic CKD stage 3-4 and vitamin D deficiency (serum 25-hydroxyvitamin D ≤20 ng/ml). We randomized patients using a 1:1 ratio to receive either two directly observed oral doses of cholecalciferol (300,000 IU) or matching placebo at baseline and 8 weeks. The primary outcome was change in endothelium-dependent brachial artery flow-mediated dilation at 16 weeks. Secondary outcome measures included changes in pulse wave velocity and circulating biomarkers. Cholecalciferol supplementation significantly increased endothelium-dependent brachial artery flow-mediated dilation at 16 weeks, whereas placebo did not (between-group difference in mean change: 5.49%; 95% confidence interval, 4.34% to 6.64%; P<0.001). Intervention also led to significant favorable changes in pulse wave velocity and circulating IL-6 levels. Thus, in nondiabetic patients with stage 3-4 CKD and vitamin D deficiency, vitamin D supplementation may improve vascular function. This study is registered with the Clinical Trials Registry of India (no.: CTRI/2013/05/003648). SN - 1533-3450 UR - https://www.unboundmedicine.com/medline/citation/28667080/A_Randomized_Trial_of_Vitamin_D_Supplementation_on_Vascular_Function_in_CKD_ L2 - https://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=28667080 DB - PRIME DP - Unbound Medicine ER -