A Randomized Trial of Vitamin D Supplementation on Vascular Function in CKD

J Am Soc Nephrol. 2017 Oct;28(10):3100-3108. doi: 10.1681/ASN.2017010003. Epub 2017 Jun 30.

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).

Keywords: Vitamin D; cardiovascular disease; chronic kidney disease.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / prevention & control*
  • Dietary Supplements
  • Endothelium, Vascular / drug effects
  • Female
  • Humans
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Pulse Wave Analysis
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / complications*
  • Vascular Stiffness / drug effects
  • Vasodilation / drug effects*
  • Vitamin D / pharmacology
  • Vitamin D / therapeutic use*
  • Vitamins / pharmacology
  • Vitamins / therapeutic use*

Substances

  • Biomarkers
  • Interleukin-6
  • Vitamins
  • Vitamin D
  • C-Reactive Protein