Annamalai Chandrashekar, Viswanathan Pragasam
Renal Research Lab, Pearl Research Park, School of Biosciences and Technology, VIT, Vellore 632014, Tamil Nadu, India.
Biomolecules. 2025 Apr 15;15(4):586. doi: 10.3390/biom15040586.
Vitamin D is a sterol prohormone with no intrinsic biological activity. Calcitriol, the active form of vitamin D, is synthesized in the kidneys. It has well-known pleiotropic and cytoprotective properties. In addition to regulating parathyroid hormone secretion and enhancing gut calcium absorption, it exhibits antioxidant, anti-inflammatory, antiproliferative, and antineoplastic effects. However, the role of vitamin D in AKI is unclear, unlike in CKD. Thus, this review aimed to understand how dysregulated vitamin D homeostasis occurs in AKI, as well as to explore how vitamin D deficiency and excess influence AKI. A comprehensive literature search was conducted between January 2000 and June 2024 to uncover relevant works detailing vitamin D homeostasis in health as well as investigating the impact of vitamin D deficiency and excess in humans, animals, and in vitro cell models of AKI. According to the findings of this review, vitamin D appears to have a reciprocal relationship with AKI. Acute renal injury, among other factors, can cause hypo- or hypervitaminosis D. Conversely, AKI can also be caused by vitamin D deficiency and toxicity. Even though hypovitaminosis D is associated with AKI, it is uncertain how it impacts AKI outcomes in distinct clinical scenarios. Newer therapeutic options might emerge as a result of understanding these challenges. Vitamin D supplementation may ameliorate renal injury but needs further validation. Furthermore, hypervitaminosis D has also been implicated in AKI by causing hypercalcemia and hyperphosphatemia. It is crucial to avoid prolonged, uncontrolled, and unsupervised supraphysiological vitamin D administration, especially intramuscular injection.
维生素D是一种没有内在生物活性的甾醇前体激素。维生素D的活性形式骨化三醇在肾脏中合成。它具有众所周知的多效性和细胞保护特性。除了调节甲状旁腺激素分泌和增强肠道对钙的吸收外,它还具有抗氧化、抗炎、抗增殖和抗肿瘤作用。然而,与慢性肾脏病不同,维生素D在急性肾损伤中的作用尚不清楚。因此,本综述旨在了解急性肾损伤中维生素D稳态失调是如何发生的,以及探讨维生素D缺乏和过量如何影响急性肾损伤。我们在2000年1月至2024年6月期间进行了全面的文献检索,以发现详细阐述健康状态下维生素D稳态以及研究维生素D缺乏和过量对急性肾损伤的人类、动物和体外细胞模型影响的相关研究。根据本综述的结果,维生素D似乎与急性肾损伤存在相互关系。急性肾损伤等因素可导致维生素D缺乏或过量。相反,维生素D缺乏和毒性也可导致急性肾损伤。尽管维生素D缺乏与急性肾损伤有关,但在不同临床情况下它如何影响急性肾损伤的结局尚不确定。了解这些挑战可能会带来新的治疗选择。补充维生素D可能会改善肾损伤,但需要进一步验证。此外,维生素D过量也因导致高钙血症和高磷血症而与急性肾损伤有关。避免长期、无控制和无监督地给予超生理剂量的维生素D,尤其是肌肉注射,至关重要。