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- Title
Vitamin D does not improve the metabolic health of patients with chronic kidney disease stage 3-4: A randomized controlled trial.
- Authors
Petchey, William G; Hickman, Ingrid J; Prins, Johannes B; Hawley, Carmel M; Johnson, David W; Isbel, Nicole M
- Abstract
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.
- Subjects
VITAMIN D; METABOLISM; KIDNEY diseases; RANDOMIZED controlled trials; CHOLECALCIFEROL
- Publication
Nephrology, 2013, Vol 18, Issue 1, p26
- ISSN
1320-5358
- Publication type
Article
- DOI
10.1111/j.1440-1797.2012.01662.x