Messa Piergiorgio, Regalia Anna, Alfieri Carlo Maria
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy.
via Festa del Perdono, Università degli Studi di Milano, Milano 20122, Italy.
Nutrients. 2017 May 27;9(6):550. doi: 10.3390/nu9060550.
Reduced levels of nutritional vitamin D are commonly observed in most chronic kidney disease (CKD) patients and particularly in patients who have received a kidney transplant (KTx). In the complex clinical scenario characterizing the recipients of a renal graft, nutritional vitamin D deficiency has been put in relation not only to the changes of mineral and bone metabolism (MBM) after KTx, but also to most of the medical complications which burden KTx patients. In fact, referring to its alleged pleiotropic (non-MBM related) activities, vitamin D has been claimed to play some role in the occurrence of cardiovascular, metabolic, immunologic, neoplastic and infectious complications commonly observed in KTx recipients. Furthermore, low nutritional vitamin D levels have also been connected with graft dysfunction occurrence and progression. In this review, we will discuss the purported and the demonstrated effects of native vitamin D deficiency/insufficiency in most of the above mentioned fields, dealing separately with the MBM-related and the pleiotropic effects.
在大多数慢性肾脏病(CKD)患者中,尤其是接受肾移植(KTx)的患者,常观察到营养性维生素D水平降低。在肾移植受者复杂的临床情况中,营养性维生素D缺乏不仅与肾移植后矿物质和骨代谢(MBM)的变化有关,还与困扰肾移植患者的大多数医学并发症有关。事实上,就其所谓的多效性(与MBM无关)活性而言,维生素D被认为在肾移植受者中常见的心血管、代谢、免疫、肿瘤和感染并发症的发生中起一定作用。此外,低营养性维生素D水平还与移植肾功能障碍的发生和进展有关。在本综述中,我们将讨论天然维生素D缺乏/不足在上述大多数领域中所谓的和已证实的影响,分别探讨与MBM相关的影响和多效性影响。