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Vitamin D for Kidney Disease Unproven

Review of 76 Studies Shows Value of Vitamin D Treatment for Chronic Kidney Disease 'Uncertain'

The Analysis: Vitamin D for Kidney Disease

Palmer, Strippoli and their colleagues searched medical databases from January 1966 through July 2007 to find published studies of vitamin D compounds for chronic kidney disease. They selected 76 that met their criteria for inclusion. In all, 3,667 participants were in these 76 studies.

When they pooled the results and analyzed them, the researchers found that the vitamin D compounds did not consistently reduce the parathyroid hormone levels or reduce the risk of death, bone pain, blood vessel calcification, or other problems.

When they compared the established vitamin D sterols with placebo, the vitamin D treatments were associated with a 2.3 times higher risk of high calcium levels and a nearly two times higher risk of high phosphate in the blood. And the treatment didn't consistently reduce the parathyroid hormone levels.

Newer types of vitamin D treatment did not perform better.

The analysis is published in the Annals of Internal Medicine.

Another Perspective

In an editorial accompanying the analysis, Marcello Tonelli, MD, associate professor of medicine at the University of Alberta in Edmonton, Canada, writes: "Palmer and colleagues' findings should serve as yet another warning to the nephrology community that we do not have good evidence to defend many of our common practices."

"We need to do more research," Tonelli tells WebMD. "To figure out the best role for these medicines, a large trial or trials are needed, probably funded by a U.S. government agency such as the National Institutes of Health."

He reports as a potential conflict of interest that he receives funding from the Centre for D-Receptor Activation Research to examine vitamin D status in remote-dwelling patients on dialysis.

Message for Kidney Disease Patients

Strippoli and Palmer, too, call for more research in the area to prove the treatments work.

Meanwhile, those with chronic kidney disease should follow their doctors' advice, Strippoli says. Until more is known, patients should closely follow, in particular, advice about preventive measures suggested by their doctors, including dietary advice and recommendations to undergo longer dialysis times.

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