Rationale for Raising Current Clinical Practice Guideline Target for Serum 25-Hydroxyvitamin D in Chronic Kidney Disease.
Am J Nephrol. 2019;49(4):284-293. doi: 10.1159/000499187
Participants with Chronic Kidney Disease who had low vitamin D levels
Gave extended release vitamin D (in the form of calcifediol)
Those who achieved more than 50 ng/ml had much better outcomes
It is not clear that the extended release type (patented and very expensive) is needed
- 1 in 10 have Chronic Kidney Disease (but only 5% are aware of it) – review Sept 2019
- Poor kidneys rarely get enough or the right form of vitamin D – Feb 2019
Previous Vitamin D level conclusions for Kidneys
- Hemodialysis associated with very poor mRNA response (wonder if low vitamin D) – March 26, 2021
- Chronic Kidney Disease patients need more than 20 ng of Vitamin D – workshop conclusion Oct 2018
- Need at least 80 ng of vitamin D if have chronic kidney disease – May 2012
Is 50 ng of vitamin D too high, just right, or not enough has the following
50 - 60 ng
- Vitamin D decreases incidence of disease many charts showing great benefits 40-60 ng
- Need 30-60 ng of vitamin D for good health – Grant Jan 2011
- USANA 50 ng/ml with graph
- GrassrootsHealth.net 41 experts 40-60 ng/ml after IoM report
- Elite outdoor athletes had 52 ng of vitamin D – March 2013
- Vitamin D is needed for human fertility – goal is 50 ng – Sept 2018
- Vitamin D - at least 4,000 IU to achieve 40-60 ng and reduce risk of early death – Holick June 2018
- Sports benefits from up to 50 ng of Vitamin – meta-analysis - Nov 2012
- Need 51 ng to avoid premature ejaculation 2018
> 60 ng
- Noticed bones heal faster when >60 ng of vitamin D
- Need at least 80 ng of vitamin D if have chronic kidney disease – May 2012
- Many sleep disorders cured with vitamin D levels of 60 to 80 nanograms – May 2012
- Clinical Trial: Colon Cancer and 80-100 ng
- Dr. who got patients to vitamin D level of 80 ng - went out of business, patients became too healthy
- Autoimmune diseases such as MS treated/reversed - 150 ng of vitamin D
- Comparing High-dose vitamin D therapies 60-150 ng
Kidney category starts with
Overview Kidney and vitamin D contains the following summary
- FACT: The Kidneys are not the primary way to activate vitamin D; the tissues are
- FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
- FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
- FACT: There are many ongoing intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
- FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
- FACT: 38% of seniors have Chronic Kidney Disease and most are unaware of it CDC statistics 2020
- FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
- Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
Nanoemulstion vitamin D (inside cheek, topically) gets activated Vitamin D to the cells without the need for healthy kidney, liver, or intestine
Calcitriol - which bypasses the need for the kidney to activate vitamin D
Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012 - Category Kidney and Vitamin D contains
229 items
Getting Vitamin D into your body has the following grapbical summary
CTx-1 = Serum collagen type 1 C-telopeptide
P1NP = Intact procollagen type 1 N-terminal propeptideStrugnell SA1, Sprague SM2, Ashfaq A3, Petkovich M4, Bishop CW3.
1 Renal Division, OPKO Health, Inc., Miami, Florida, USA, sstrugnell at opko.com.
2 Department of Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.
3 Renal Division, OPKO Health, Inc., Miami, Florida, USA.
4 Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.BACKGROUND:
Vitamin D repletion is recommended for secondary hyperparathyroidism (SHPT) and associated vitamin D insufficiency (VDI) in chronic kidney disease (CKD), but optimal levels of serum total 25-hydroxyvitamin D remain undefined. Clinical practice guidelines target sufficiency, whereas recent data indicate that higher levels are required to control the elevation of intact parathyroid hormone (iPTH) as CKD advances. This secondary analysis of 2 randomized controlled trials seeks to identify the minimum level of mean serum 25-hydroxyvitamin D required to control SHPT arising from VDI in stage 3 or 4 CKD.METHODS:
Adult subjects (n = 429) with SHPT, VDI, and stage 3 or 4 CKD were stratified by stage and treated daily with either extended-release calcifediol (ERC) or placebo in 2 identical, parallel, randomized, double-blind studies. After treatment for 26 weeks, all subjects were ranked by the level of serum total 25-hydroxyvitamin D and divided into quintiles in order to examine the relationships between the degree of vitamin D repletion and the associated changes in plasma iPTH, serum bone turnover markers, calcium, phosphorus, intact fibroblast growth factor 23 (FGF23) and vitamin D metabolites, estimated glomerular filtration rate (eGFR), and urine calcium:creatinine (Ca:Cr) ratio.RESULTS:
Progressive increases in serum 1,25-dihydroxyvitamin D and reductions in plasma iPTH and serum bone turnover markers were observed as mean posttreatment serum 25-hydroxyvitamin D rose from 13.9 ng/mL (in Quintile 1) to 92.5 ng/mL (in Quintile 5), irrespective of CKD stage. Mean serum calcium, phosphorus and FGF23, eGFR, and urine Ca:Cr ratio (collectively "safety parameters") did not significantly change from Quintile 1. Suppression of iPTH and bone turnover markers was not observed until serum 25-hydroxyvitamin D rose to at least 50.8 ng/mL (Quintile 3).CONCLUSION:
ERC therapy produced exposure-dependent reductions in plasma iPTH and bone turnover markers only when mean serum total 25-hydroxyvitamin D reached at least 50.8 ng/mL, indicating that current targets for vitamin D repletion therapy in CKD are too low. Gradual elevation of mean serum 25-hydroxyvitamin D to 92.5 ng/mL was not associated with significant adverse changes in safety parameters.More than 30 ng of vitamin D is sometimes needed (Kidney needs 50 ng) – March 2019(Cached) Printer Friendly Follow this page for updates8086 visitors, last modified 24 May, 2023, This page is in the following categories (# of items in each category)