Lim Wai H, Duncan Emma L
Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
Nephrology (Carlton). 2017 Mar;22 Suppl 2:57-64. doi: 10.1111/nep.13027.
Vitamin D is important for bone health in the general population but the value of vitamin D supplementation, and the role of 25-hydroxyvitamin D independently of 1,25-dihydroxyvitmain D, in individuals with chronic kidney disease (CKD), particularly in those who require dialysis, remains uncertain. Supplementation may improve some biochemical parameters, such as reducing PTH levels in patients to CKD-stage 4 who have vitamin D deficiency; but it remains to be established whether the role of nutritional vitamin D in maintaining bone health in the general population can be extrapolated to the CKD population. There is currently insufficient evidence to recommend conclusively that nutritional vitamin D supplementation should be prescribed to individuals with CKD who have 25-hydroxyvitamin D deficiency, either for skeletal or non-skeletal health outcomes.
维生素D对普通人群的骨骼健康很重要，但对于慢性肾脏病（CKD）患者，尤其是需要透析的患者，补充维生素D的价值以及独立于1,25-二羟维生素D的25-羟维生素D的作用仍不确定。补充维生素D可能会改善一些生化指标，比如降低维生素D缺乏的CKD 4期患者的甲状旁腺激素（PTH）水平；但营养性维生素D在普通人群中维持骨骼健康的作用是否能外推至CKD人群仍有待确定。目前尚无足够证据能确凿地建议，为25-羟维生素D缺乏的CKD患者补充营养性维生素D以改善骨骼或非骨骼健康结局。
