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Impact of vitamin D on cardiac structure and function in chronic kidney disease patients with hypovitaminosis D: a randomized controlled trial and meta-analysis

Banerjee, D; Chitalia, N; Ster, IC; Appelbaum, E; Thadhani, R; Kaski, JC; Goldsmith, D (2021) Impact of vitamin D on cardiac structure and function in chronic kidney disease patients with hypovitaminosis D: a randomized controlled trial and meta-analysis. Eur Heart J Cardiovasc Pharmacother, 7 (4). pp. 302-311. ISSN 2055-6845 https://doi.org/10.1093/ehjcvp/pvz080
SGUL Authors: Banerjee, Debasish Kaski, Juan Carlos Chis Ster, Delizia Irina

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Abstract

Aims Vitamin D deficiency is associated with cardiovascular events in chronic kidney disease (CKD) yet the impact of supplementation is controversial. Previous active vitamin D supplementation studies did not show improvement in cardiac structure or function but the effect of native vitamin D supplementation in CKD patients with low vitamin D levels is unknown. We have addressed this question via both a randomized double-blind prospective study and a meta-analysis of three randomized placebo-controlled studies. Methods and results We conducted a randomized double-blind, placebo-controlled trial of vitamin D supplementation in stable, non-diabetic, CKD three to four patients with circulating vitamin D <75nmol/L, who were receiving treatment with ACEi or ARB and had high-normal left ventricular (LV) mass. Patients were randomized to receive six directly observed doses of 100 000 IU cholecalciferol (n = 25) or matched placebo (n = 23). The primary endpoint was changed in LV mass index (LVMI) over 52 weeks, as assessed by cardiac magnetic resonance imaging. Secondary endpoints included changes in LV ejection fraction (LVEF); LV and right ventricular volumes and left and right atrial area. Vitamin D concentration increased with the administration of cholecalciferol. The change in LVMI with cholecalciferol [median (inter-quartile range), −0.25 g (−7.20 to 5.30)] was no different from placebo [−4.30 g (9.70 to 2.60)]. There was no difference in changes of LVEF; LV and right ventricular volumes and left and right atrial area. The meta-analysis of three 52-week, randomized placebo-controlled studies using active/native vitamin D supplementation showed no differences in LVMI measurements. Conclusion Vitamin D supplementation does not have beneficial effects on LV mass in CKD patients.

Item Type: Article
Additional Information: © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Cardiovascular disease, Cholecalciferol, Chronic Kidney Disease, Left Ventricular Mass, Vitamin D
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Eur Heart J Cardiovasc Pharmacother
ISSN: 2055-6845
Language: eng
Dates:
DateEvent
July 2021Published
12 December 2019Published Online
4 December 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
PG10/71/28462British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
204809/Z/16/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
PubMed ID: 31830258
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111462
Publisher's version: https://doi.org/10.1093/ehjcvp/pvz080

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