Emini Sadiku Merita
Medical Faculty, University of Prishtina "Hasan Prishtina", Prishtina, Kosovo.
Clinic of Endocrinology, University Clinical Center of Kosova, Prishtina, Kosovo.
Front Clin Diabetes Healthc. 2025 Mar 11;6:1537336. doi: 10.3389/fcdhc.2025.1537336. eCollection 2025.
Vitamin D is a hormone which is involved in many physiological processes in addition to bone metabolism and the muscular system. Based on several animal and human studies, it has been established that vitamin D plays an important role in the development of diabetic nephropathy (DN). DN is a frequent and severe chronic microvascular complication of diabetes mellitus (DM). As such, DN and cardiovascular complications are considered the main risk factors for the death of patients with DM. Recent studies have shown the renoprotective effect of VD and its receptor activators (VDRAs or VD analogs based on its effect on endothelial function, preservation of podocytes, anti-inflammatory effect, and direct influence on the renin-angiotensin aldosterone system. The renoprotective effect of VD has been shown to potentially delay the onset of DN, which is the main cause of end stage renal diseases (ESRD). The impact of vitamin D on the recovery of already existing kidney damage is debatable and doubtful. Increasing evidence has shown that the VD/VDR interaction possesses a series of renoprotective effects in DN patients based on the anti-proteinuric, anti-fibrotic, and anti-inflammatory effect, as well as the preventive effect of podocyte damage. Based on this important renoprotective effect, important data for therapeutic and effective methods for DN have also been presented. It was performed a structured search of published research literature for several databases regarding the impact of VD on the pathophysiology of DN as well as its therapeutic implications in terms of renoprotection of VD and VDRA in animal research and human clinical research as RCT, observational studies, systematic reviews and meta-analyses over the last decade.
维生素D是一种激素，除了参与骨骼代谢和肌肉系统外，还涉及许多生理过程。基于多项动物和人体研究，已证实维生素D在糖尿病肾病（DN）的发展中起重要作用。DN是糖尿病（DM）常见且严重的慢性微血管并发症。因此，DN和心血管并发症被认为是DM患者死亡的主要危险因素。最近的研究表明，维生素D及其受体激活剂（VDRAs或基于其对内皮功能、足细胞保护、抗炎作用以及对肾素-血管紧张素-醛固酮系统的直接影响的维生素D类似物）具有肾脏保护作用。维生素D的肾脏保护作用已被证明可能延迟DN的发生，而DN是终末期肾病（ESRD）的主要原因。维生素D对已存在的肾脏损伤恢复的影响存在争议且令人怀疑。越来越多的证据表明，基于抗蛋白尿、抗纤维化和抗炎作用以及对足细胞损伤的预防作用，维生素D/维生素D受体相互作用在DN患者中具有一系列肾脏保护作用。基于这种重要的肾脏保护作用，也提出了关于DN治疗和有效方法的重要数据。对几个数据库中已发表的研究文献进行了结构化检索，内容涉及维生素D对DN病理生理学的影响及其在动物研究和人体临床研究（作为随机对照试验、观察性研究、系统评价和荟萃分析）中维生素D和维生素D受体激活剂在肾脏保护方面的治疗意义，时间跨度为过去十年。
