Department of Medicine, The University of Chicago, Chicago, Illinois 60637, USA.
Curr Opin Nephrol Hypertens. 2012 Jan;21(1):72-9. doi: 10.1097/MNH.0b013e32834de4ee.
Great progress has been made in recent years in understanding the expanding roles of the vitamin D endocrine system beyond calcemic regulation, including pathophysiological actions in the kidney and the cardiovascular system. The purpose of this review is to update the recent advance regarding the effects of vitamin D and its analogs on the renal and cardiovascular system.
Vitamin D deficiency is not only widely associated with chronic kidney disease and cardiovascular disease in humans, but may also accelerate the disease progression. Dysregulation of vitamin D metabolism caused by renal insufficiency contributes to the low vitamin D status. Preclinical and clinical studies have demonstrated impressive therapeutic outcome with low-calcemic vitamin D analogs in renal and cardiovascular disease. The mechanism underlying the renal and cardiovascular protection involves regulation of multiple signaling pathways by vitamin D including nuclear factor κB, Wnt/β-catenin and the renin-angiotensin system.
The renal and cardiovascular protective activity of vitamin D revealed in recent studies has profound clinical implications. Nutritional correction of vitamin D deficiency and treatment with vitamin D analogs could be therapeutic options for renal and cardiovascular problems. New vitamin D analogs with better renal and cardiovascular therapeutic efficacy are highly desired. More randomized trials are needed to address these issues.
近年来，人们在理解维生素 D 内分泌系统的作用方面取得了重大进展，其作用不仅局限于钙代谢调节，还包括在肾脏和心血管系统中的病理生理作用。本文的目的是更新关于维生素 D 及其类似物对肾脏和心血管系统的影响的最新进展。
维生素 D 缺乏不仅与人类的慢性肾脏病和心血管疾病广泛相关，而且可能加速疾病进展。肾功能不全导致的维生素 D 代谢失调导致维生素 D 状态低下。临床前和临床研究表明，低钙维生素 D 类似物在肾脏和心血管疾病中有显著的治疗效果。维生素 D 通过核因子 κB、Wnt/β-连环蛋白和肾素-血管紧张素系统等多种信号通路的调节，发挥其肾脏和心血管保护作用。
最近的研究揭示了维生素 D 的肾脏和心血管保护作用，这具有深远的临床意义。营养纠正维生素 D 缺乏和使用维生素 D 类似物治疗可能是肾脏和心血管问题的治疗选择。人们迫切需要具有更好的肾脏和心血管治疗效果的新型维生素 D 类似物。需要更多的随机试验来解决这些问题。
