February 8, 2023

A commentary by Mayo Clinic Nephrologist Rajiv Kumar, M.D., in the current issue of the journal Kidney International suggests that Vitamin D may improve the treatment of renal disease. Dr. Kumar says that while larger clinical trials are needed, he believes doctors should start treating patients with diabetes who have low serum levels of 25-hydroxyvitamin (the active form of vitamin D) with vitamin D3 to help slow down the progression of kidney damage. Dr. Kumar cautions that more research is needed and that patients should always consult their doctors before consuming vitamin D supplements on their own.

Investigators from from britain looked at the efficacy of vitamin d3 which is the naturally produced vitamin on preventing protein excretion in patients who have diabetes and kidney disease so many of these patients were at a point where their kidneys had begun to fail but had not failed to the same to the extent that they required dialysis so these were people

With kidney disease as a result of diabetes prior to the initiation of dialysis and in this study the investigators gave vitamin d3 in doses sufficient to increase the levels to a particular concentration and showed that the people who got vitamin d3 had less protein in the urine and they had less of a amounts of a particular substance known as transforming growth

Factor beta that is responsible for fibrosis or the development of fibrosis in the kidney it was a small study and it’s not entirely certain that this can be extrapolated to large groups of patients but it does suggest that among non-smoking diabetics there is a beneficial effect of giving vitamin d3 in in preventing the progression of kidney disease or certainly

In preventing an increase in protein excretion and the formation of this substance that causes fibrosis or scarring in the kidney now i would hasten to add that the study is very small they got different results in smokers versus non-smokers which is not easily and the definitive tests for looking at progression of kidney function were not done so i think but but

Certainly the data is very suggestive of there being a beneficial effect of vitamin d3 administration in patients who have diabetes low vitamin d levels to begin with and who have kidney dysfunction at the same time now i think that when vitamin d3 is given in the amounts that were given in this study the the toxicity or some of the side effects of vitamin d are

Very the incidence of those side effects is very low so we would be safe to give amounts in the amount that was given in the study without causing any side effects clearly larger trials are needed to confirm these studies with more definitive endpoints but i think it’s a step in the right direction showing that the administration of vitamin d3 may be helpful in a

Subset of patients who have chronic kidney failure in this case due to diabetes i would caution it against doing that i think that if someone has diabetes and chronic kidney disease they should see their doctor who could then measure the levels of a vitamin d metabolite in the blood called 25 hydroxy vitamin d if the levels of that particular substance were on the

Low side then under those circumstances under supervision administering vitamin d3 would be of help because it would prevent more protein from appearing in the urine and potentially more damage from occurring the problems with giving indiscriminate vitamin d in doses that can cause calcium and phosphorous to rise is that that elevation in calcium and phosphorus

Can further damage the kidney and so this has to be done under supervision

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Vitamin D and Renal Disease – Mayo Clinic By Mayo Clinic