Department of Nephrology, Amsterdam University Medical Center, Amsterdam, the Netherlands; Division of Diabetes and Metabolism, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.
Kidney Research Institute and Division of Nephrology, University of Washington, Seattle, Washington, USA.
Kidney Int. 2023 Oct;104(4):698-706. doi: 10.1016/j.kint.2023.07.010. Epub 2023 Aug 2.
Vitamin D supplements have long been advocated for people with chronic kidney disease based on data from observational studies among the general population and people with chronic kidney disease. These data consistently suggested that higher circulating concentrations of 25-hydroxyvitamin D are associated with improved fracture, cardiovascular, cancer, and mortality outcomes. In the past few years, large clinical trials have been conducted to assess the effects of vitamin D supplements on a range of clinically relevant outcomes. Most of these studies were performed in the general population, but they also enrolled people with chronic kidney disease. Virtually all of these trials were negative and contradicted the observational data. In this review, the key observational data and clinical trials are summarized, and potential explanations for the discrepancies between these studies are discussed.
维生素 D 补充剂长期以来一直被推荐给慢性肾脏病患者，这是基于一般人群和慢性肾脏病患者的观察性研究数据。这些数据一致表明，循环 25-羟维生素 D 浓度较高与改善骨折、心血管、癌症和死亡率结局有关。在过去的几年中，已经进行了大量的临床试验来评估维生素 D 补充剂对一系列临床相关结局的影响。这些研究大多数是在普通人群中进行的，但也招募了慢性肾脏病患者。几乎所有这些试验都是阴性的，与观察性数据相矛盾。在这篇综述中，总结了关键的观察性数据和临床试验，并讨论了这些研究之间差异的潜在解释。
