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Native vitamin D in CKD and renal transplantation: meaning and rationale for its supplementation

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Abstract

Chronic kidney disease (CKD) poses a significant epidemiological challenge, necessitating effective patient management strategies. Nutritional intervention, particularly vitamin D supplementation, has garnered attention for its potential therapeutic utility in CKD. Despite widespread acknowledgment of the importance of vitamin D, particularly in bone and mineral metabolism, its supplementation in CKD patients for non-skeletal purposes remains contentious due to limited evidence. Hypovitaminosis D linked with CKD substantially contributes to disturbances in mineral and bone metabolism, increasing the risks of cardiovascular complications and skeletal disorders. Notably, CKD patients experience progressive vitamin D deficiency, exacerbating as the disease progresses. Guidelines recommend monitoring 25-hydroxyvitamin D (25 (OH)-D) levels due to their correlation with mineral metabolism parameters, although robust evidence for recommending supplementation is lacking. The primary aim of this paper is to focus on the main open questions regarding vitamin D supplementation in CKD, reporting the current evidence concerning the role of vitamin D supplementation in CKD and in renal transplant recipients.

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Acknowledgements

The authors thank Marina Balderacchi and Emilietta Brigati for their kind collaboration in the health research and realization of this study.

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“This research received no external funding”.

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Authors and Affiliations

  1. Department of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    Carlo Alfieri, Paolo Molinari, Simone Vettoretti, Anna Maria Pisacreta, Margherita Di Naro & Giuseppe Castellano

  2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Carlo Alfieri & Giuseppe Castellano

  3. Post-Graduate School of Specialization in Nephrology, University of Milan, Milan, Italy

    Paolo Molinari, Anna Maria Pisacreta & Margherita Di Naro

  4. Institute of Clinical Physiology (IFC), Pisa and Department of Medicine, National Research Council (CNR), University of Padova, Padua, Italy

    Maria Fusaro

  5. Nephrology Department, University Hospital Germans Trias i Pujol (HGITP) & REMAR-IGTP Group, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Badalona, Catalonia, Spain

    Jordi Bover

  6. Nephrology, Dialysis and Renal Transplant Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, Bologna, Italy

    Giuseppe Cianciolo

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Alfieri, C., Molinari, P., Vettoretti, S. et al. Native vitamin D in CKD and renal transplantation: meaning and rationale for its supplementation. J Nephrol 37, 1477–1485 (2024). https://doi.org/10.1007/s40620-024-02055-x

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