Vitamin D does not improve the metabolic health of patients with chronic kidney disease stage 3-4: a randomized controlled trial

Petchey, William G., Hickman, Ingrid J., Prins, Johannes B., Hawley, Carmel M., Johnson, David W. and Isbel, Nicole M. (2013) Vitamin D does not improve the metabolic health of patients with chronic kidney disease stage 3-4: a randomized controlled trial. Nephrology, 18 1: 26-35. doi:10.1111/j.1440-1797.2012.01662.x


Author Petchey, William G.
Hickman, Ingrid J.
Prins, Johannes B.
Hawley, Carmel M.
Johnson, David W.
Isbel, Nicole M.
Title Vitamin D does not improve the metabolic health of patients with chronic kidney disease stage 3-4: a randomized controlled trial
Journal name Nephrology   Check publisher's open access policy
ISSN 1320-5358
1440-1797
Publication date 2013-01
Year available 2012
Sub-type Article (original research)
DOI 10.1111/j.1440-1797.2012.01662.x
Volume 18
Issue 1
Start page 26
End page 35
Total pages 10
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell
Collection year 2013
Language eng
Formatted abstract
Aim: To assess the impact of vitamin D supplementation (cholecalciferol) on the insulin sensitivity and metabolic health of patients with chronic kidney disease (CKD).

Methods: Twenty-eight adult patients with CKD stages 3–4 were recruited from the outpatient department of the Princess Alexandra Hospital (Brisbane, Australia) to a double-blind randomized trial of cholecalciferol (vitamin D3) 2000 IU/day or placebo for 6 months. Metabolic parameters at baseline were compared with 20 non-CKD adults. The primary outcome was an improvement in insulin resistance (glucose disposal rate, GDR) at 6 months (quantified by hyperinsulinaemic euglycaemic clamp). Carbohydrate and lipid oxidation rates were assessed by indirect calorimetry.

Results: At baseline, patients were significantly insulin-resistant compared with lean younger non-CKD individuals (n = 9; GDR 3.42 vs 5.76 mg/kg per minute, P = 0.001), but comparable with their age-, gender- and weight-matched non-CKD counterparts (n = 11; 3.42 vs 3.98 mg/kg per minute, P = 0.4). 25-Hydroxyvitamin D did not change in the placebo group, but rose from 95 ± 37 to 146 ± 25 nmol/L with treatment (P = 0.0001). Post treatment, there was no difference in GDR between groups (GDR 3.38 vs 3.52 mg/kg per minute, ancova P = 0.4). There was a relative increase in hyperinsulinaemic oxidative disposal of glucose with treatment (within-group P = 0.03).

Conclusion: Supplementation with cholecalciferol in CKD 3–4 results in appreciable increases in 25-hydroxyvitamin D concentrations, but does not increase insulin sensitivity. The insulin resistance observed was similar among age-, sex- and body mass index-matched individuals with and without CKD. Whether renal dysfunction per se has any influence on the insulin sensitivity of an individual should be the subject of future work.
Keyword Cholecalciferol
Chronic kidney disease
Insulin resistance
Randomized controlled trial
Vitamin D
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 17 December 2012.

 
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