Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Curr Opin Nephrol Hypertens. 2020 Mar;29(2):243-247. doi: 10.1097/MNH.0000000000000591.
Vitamin D deficiency is common in patients with kidney disease and many patients receive vitamin D supplementation. Several large, well-designed clinical trials have been published in the last few years evaluating the effects of vitamin D supplementation on important outcomes for patients with kidney disease including effects on cardiovascular disease, secondary hyperparathyroidism, and kidney disease progression.
Several negative trials have been published showing no effect of cholecalciferol supplementation on cardiovascular events, kidney disease progression, and albuminuria. Long-term supplementation does not appear to be associated with kidney stone disease. Vitamin D supplementation decreases parathyroid hormone (PTH) levels and high levels of 25-hydroxyvitamin D may be required for maximal suppression.
There appear to be no effects of vitamin D supplementation on noncalcemic outcomes including progression of kidney disease, albuminuria, or cardiovascular disease. The primary reason to use vitamin D in kidney disease remains to lower PTH levels.
维生素 D 缺乏在肾病患者中很常见，许多患者接受维生素 D 补充。过去几年发表了几项大型、精心设计的临床试验，评估了维生素 D 补充对肾病患者重要结局的影响，包括对心血管疾病、继发性甲状旁腺功能亢进症和肾脏疾病进展的影响。
发表了几项阴性试验，表明胆钙化醇补充对心血管事件、肾脏疾病进展和蛋白尿没有影响。长期补充似乎与肾结石病无关。维生素 D 补充可降低甲状旁腺激素（PTH）水平，高水平的 25-羟维生素 D 可能需要最大程度的抑制。
维生素 D 补充似乎对非钙结局（包括肾脏疾病进展、蛋白尿或心血管疾病）没有影响。在肾脏病中使用维生素 D 的主要原因仍然是降低 PTH 水平。
