Document Detail


Vitamin D does not improve the metabolic health of patients with chronic kidney disease stage 3-4: a randomized controlled trial.
MedLine Citation:
PMID:  23043683     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To assess the impact of vitamin D supplementation (cholecalciferol) on the insulin sensitivity and metabolic health of patients with chronic kidney disease (CKD).
METHODS: Twenty-eight adult patients with CKD stages 3-4 were recruited from the outpatient department of the Princess Alexandra Hospital (Brisbane, Australia) to a double-blind randomized trial of cholecalciferol (vitamin D3) 2000 IU/day or placebo for 6 months. Metabolic parameters at baseline were compared with 20 non-CKD adults. The primary outcome was an improvement in insulin resistance (glucose disposal rate, GDR) at 6 months (quantified by hyperinsulinaemic euglycaemic clamp). Carbohydrate and lipid oxidation rates were assessed by indirect calorimetry.
RESULTS: At baseline, patients were significantly insulin-resistant compared with lean younger non-CKD individuals (n = 9; GDR 3.42 vs. 5.76 mg/kg per minute, P = 0.001), but comparable with their age-, gender- and weight-matched non-CKD counterparts (n = 11; 3.42 vs. 3.98 mg/kg per minute, P = 0.4). 25-Hydroxyvitamin D did not change in the placebo group, but rose from 95 ± 37 to 146 ± 25 nmol/L with treatment (P = 0.0001). Post treatment, there was no difference in GDR between groups (GDR 3.38 vs. 3.52 mg/kg per minute, ancova P = 0.4). There was a relative increase in hyperinsulinaemic oxidative disposal of glucose with treatment (within-group P = 0.03).
CONCLUSION: Supplementation with cholecalciferol in CKD 3-4 results in appreciable increases in 25-hydroxyvitamin D concentrations, but does not increase insulin sensitivity. The insulin resistance observed was similar among age-, sex- and body mass index-matched individuals with and without CKD. Whether renal dysfunction per se has any influence on the insulin sensitivity of an individual should be the subject of future work.
Authors:
William G Petchey; Ingrid J Hickman; Johannes B Prins; Carmel M Hawley; David W Johnson; Nicole M Isbel; Emma L Duncan
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  18     ISSN:  1440-1797     ISO Abbreviation:  Nephrology (Carlton)     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-20     Completed Date:  2013-06-03     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  26-35     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. Nephrology © 2012 Asian Pacific Society of Nephrology.
Affiliation:
Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cholecalciferol / therapeutic use*
Double-Blind Method
Female
Humans
Insulin Resistance*
Male
Metabolic Diseases / drug therapy*,  etiology
Renal Insufficiency, Chronic / complications,  metabolism*
Severity of Illness Index
Treatment Failure
Vitamins / therapeutic use*
Chemical
Reg. No./Substance:
0/Vitamins; 67-97-0/Cholecalciferol
Comments/Corrections
Erratum In:
Nephrology (Carlton). 2013 Jun;18(6):481
Note: Duncan, Emma L [added]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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