Assistant Professor of Nephrology, Head of Department of Medicine, College of Medicine, University of Sulaimani ,Kurdistan Region-Iraq.
Cell Mol Biol (Noisy-le-grand). 2022 May 31;68(5):7-15. doi: 10.14715/cmb/2022.68.5.2.
Vitamin D insufficiency is common in patients suffering from end-stage renal disease (ESRD). In contrast, vitamin D supplementation could improve the status of ESRD patients (ESRDP). However, this effect's molecular mechanism is not fully understood. Therefore, this study aimed to assess vitamin D supplementation's impact on inflammation and oxidative signaling pathways in ESRDP. 104 ESRDP were divided into placebo (53) and vitamin D (51) groups. They were also categorized into four subgroups based on the severity of vitamin D deficiency. The dose of vitamin D3 (0.25-0.5mg/day) supplementation was determined based on plasma levels of calcium and parathyroid hormone (PTH). Vitamin D supplementation was performed for eight weeks. Serum levels of calcium, phosphorus, PTH, albumin, creatinine, ALP, and glomerular filtration along with antioxidant enzymes, malondialdehyde, and pro-inflammatory factors were measured. Moreover, the Nrf2 and NF-ĸB expression was evaluated in whole blood. According to the results, vitamin D supplementation improved the status of patients with ESRD significantly as compared with the placebo group (p<0.05). In addition, the expression of NF-ĸB and the serum levels of pro-inflammatory factors and malondialdehyde were significantly reduced. Finally, the expression of Nrf-2 and the serum of antioxidant enzymes were raised in the vitamin D group as compared with the placebo group (p<0.05). Vitamin D reduces clinical and metabolic symptoms in ESRDP by modulating gene expression (in oxidative stress and inflammation).
维生素 D 不足在患有终末期肾病（ESRD）的患者中很常见。相比之下，维生素 D 补充可以改善 ESRD 患者的状况（ESRDP）。然而，其分子机制尚不完全清楚。因此，本研究旨在评估维生素 D 补充对 ESRDP 中炎症和氧化信号通路的影响。104 名 ESRDP 患者分为安慰剂（53 名）和维生素 D（51 名）组。他们还根据维生素 D 缺乏的严重程度分为四组亚组。根据血浆钙和甲状旁腺激素（PTH）水平确定维生素 D3（0.25-0.5mg/天）补充剂的剂量。维生素 D 补充剂持续八周。测量血清钙、磷、PTH、白蛋白、肌酐、碱性磷酸酶和肾小球滤过率以及抗氧化酶、丙二醛和促炎因子的水平。此外，还评估了全血中 Nrf2 和 NF-κB 的表达。结果表明，与安慰剂组相比，维生素 D 补充显著改善了 ESRD 患者的状况（p<0.05）。此外，NF-κB 的表达以及血清中促炎因子和丙二醛的水平显著降低。最后，与安慰剂组相比，维生素 D 组 Nrf-2 的表达和抗氧化酶的血清水平升高（p<0.05）。维生素 D 通过调节氧化应激和炎症中的基因表达来减轻 ESRDP 的临床和代谢症状。
