Alvarez Jessica, Wasse Haimanot, Tangpricha Vin
Dermatoendocrinol. 2012 Apr 1;4(2):118-27. doi: 10.4161/derm.20014.
Vitamin D deficiency is associated with a variety of skeletal, cardiometabolic, and immunologic co-morbidities that are present in chronic kidney disease (CKD). We performed a systematic review to investigate the effects of vitamin D supplementation, in the form of ergocalciferol or cholecalciferol, on various health outcomes in early CKD. Seventeen clinical trials were identified, only two of which were randomized, placebo controlled trials. The majority of studies supplementing with > 2,000 IU/day of cholecalciferol achieved optimal vitamin D status, whereas studies supplementing with ergocalciferol were less consistent. Studies varied widely in their effects on lowering serum parathyroid hormone concentrations. Few studies investigated effects of vitamin D treatment on other clinical health indicators in early CKD. Rigorous studies are necessary to investigate optimal vitamin D dosing strategies in early CKD for the maintenance of adequate vitamin D status, management of secondary hyperparathyroidism and improvement of non-skeletal related clinical outcomes.
维生素D缺乏与慢性肾脏病（CKD）中存在的多种骨骼、心脏代谢和免疫合并症相关。我们进行了一项系统评价，以研究以麦角钙化醇或胆钙化醇形式补充维生素D对早期CKD各种健康结局的影响。共识别出17项临床试验，其中只有两项是随机、安慰剂对照试验。大多数补充剂量>2000IU/天胆钙化醇的研究实现了最佳维生素D状态，而补充麦角钙化醇的研究结果则不太一致。各研究在降低血清甲状旁腺激素浓度方面的效果差异很大。很少有研究调查维生素D治疗对早期CKD其他临床健康指标的影响。有必要进行严谨的研究，以探究早期CKD中最佳维生素D给药策略，以维持充足的维生素D状态、管理继发性甲状旁腺功能亢进并改善非骨骼相关的临床结局。
