May 29, 2023

Kidney disease is associated with changes in bone health and mineral balance. Vitamin D is a fat-soluble vitamin that is essential for life and is crucial for calcium balance and bone health. The kidneys are central in the activation of vitamin D and play a key role in regulating circulating levels.

Hey guys this is dr. ezra with integrative kidney solutions and today i’m going to be talking to you about vitamin d and kidney health the kidneys plays an essential role in activating vitamin d and regulating the circulating level of vitamin d and chronic kidney disease is associated with a lot of changes that can happen with vitamin d level and activation we

Are trying to make it as simple as possible here in this video but if you are interested in more details so please make sure you check out our blog that we wrote about vitamin d and kidney health so let’s do this vitamin d is a fat-soluble vitamin and it plays an essential role in bone formation and bone health but also plays a lot of important roles throughout

Our body and we’ll talk about this and more details in the video vitamin d is actually made from cholesterol and there’s two types of vitamin d that i would like you to just remember one is vitamin d2 which is the plant derived vitamin d or ergo calcifer oh and the other one is the vitamin d3 or the animal derived vitamin d which is the one that we make in our

Skin from sun exposure our skin is actually our factory that makes vitamin d3 for us with uv rays and sun exposure but vitamin d is not only a vitamin it is essential and we can get it from the diet but also acts as a hormone because we can make it in the skin but also because it has many receptors that are actually found to be present in many of our cells all

Throughout the body pretty much all our organs have vitamin d receptors and yes we call vitamin d as the sunshine vitamin but there are a lot of factors that plays in our body’s ability to make vitamin d so sometimes it’s not enough to get vitamin d from sun exposure because it varies based on geographic location based on you know our skin color and based on also

Our genetic abilities but luckily we can get vitamin d from a diet that is high in vitamin d and also from high quality supplements and the food that is high in vitamin d is basically fish and also egg yolk in addition to that the plant the only source of plant-based vitamin d is actually mushroom and what’s good is that you can actually increase the amount of

Vitamin d2 in mushroom by by sun exposure many people associate vitamin d with milk and juices because the beverage companies are so smart they market their beverages by saying that these are good source of vitamin d and calcium but these are actually they’re these the vitamin d is actually added to the manufacturing process to make juices that are not good for

You look like they are good for you a couple of four is about activating vitamin d so whatever vitamin d we make in our skin or we eat in our food or from high quality supplement it goes and circulate in the blood with a protein called vitamin d binding protein which bind all kind of vitamin d where then goes to the liver to become active and then a second step of

Activation occurred and the kidney which produces the most active form of vitamin d and throughout this process there are multiple enzymes i’m not going to go into details you can read the bottom in the blog but any genetic variation in these enzyme can lead to severe consequences and changes in vitamin d levels so what happened to vitamin d with kidney disease a

Lot of things happen during that process with with loss of kidney function there’s a gradual decline in vitamin d level there’s a lot of factors that play a role in why we are not able to produce active vitamin d as kidney function decline one of them is phosphorus retention and another one is basically the kidneys tissue ability i mean the loss of kidney tissue

Will decrease the amount of vitamin d that is being activated but really what’s interesting is that eighty percent of people were found to have eighty percent of people who have kidney disease were found to have low level of nutritional vitamin d and we don’t really know the reason behind this but all in all we we know that vitamin d level is lower and advanced

Kidney disease especially as the kidney function decline we see gradual decline in vitamin d level whether it’s the active or the 25 hydroxy vitamin d which is the nutritional what i call the nutritional vitamin d a little bit of word about the parathyroid hormone so the per thyroid gland these are four glands located here they’re next to the thyroid glands and

This this is why they’re the gland is called the paratha roid grandpere amin next to so it’s not the thyroid so don’t confuse it with thyroid again so the the most important job of parathyroid hormone is to actually maintain calcium and normal level in the blood because calcium in the blood is important for our muscle function and the most important muscle of all

Is our heart and with loss of vitamin d activation we would with advanced kidney disease work will start noticing a decline in the absorption of calcium from the gut and we will lose the ability to put that calcium where we end up in the bone so in in advanced cases with the calcium level start declining and the parathyroid want to maintain the calcium and normal

Level but it does that by making sure that calcium come from wherever possible so it could be coming from your gut it could be coming from reabsorption of calcium from the kidneys but also it could be coming from the bone so activating so increasing amount of parathyroid hormone because of decreased calcium level in the blood can make your bone weak and a question

That we get asked often is what is the normal level of vitamin d what is the target level of 25 hydroxy vitamin e and really the answer to that is we do not know for sure many studies were done on that you know level below 15 is definitely not not good for you but we believe that we argue that levels of about 50 and above are crucial for our body’s health and ability

To fight infection and for to maintain good heart and vascular function and for our immune system in addition to our bone health so unfortunately conventional medicine has failed to address the issues with vitamin d and kidney health and if you read many of the guidelines they’re all based on expert opinion that we do not know what level of vitamin d should be what

Level of parathyroid hormone should be and in the past they use vitamin d analog for the prevention of vitamin d related bone disease and there are some successes in that and they’re still going right now but when we talk about vitamin d and we address vitamin d and bone health and kidney patient and vascular health for kidney patient it’s not only enough to think

About that we need to think about many dietary factors calcium absorption magnesium and other nutrients that play an important factor in activating vitamin d and many genetic and epigenetic changes that can lead to active or inactive vitamin d because there might be more than just a recommendation of get some more sun or get some good quality vitamin d supplement

To achieve an adequate level in some individuals so it is really important that we individualize and personalize the approach to vitamin d to achieve great kidney health and bone health

Transcribed from video
Vitamin D and Kidney health By Integrative Kidney Institute